EP0878168A1 - Electrosurgical hemostatic device - Google Patents
Electrosurgical hemostatic device Download PDFInfo
- Publication number
- EP0878168A1 EP0878168A1 EP98303753A EP98303753A EP0878168A1 EP 0878168 A1 EP0878168 A1 EP 0878168A1 EP 98303753 A EP98303753 A EP 98303753A EP 98303753 A EP98303753 A EP 98303753A EP 0878168 A1 EP0878168 A1 EP 0878168A1
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- European Patent Office
- Prior art keywords
- tissue
- pole
- electrodes
- interfacing
- end effector
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Images
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/1206—Generators therefor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
- A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
- A61B18/1447—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod wherein sliding surfaces cause opening/closing of the end effectors
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1402—Probes for open surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00875—Resistance or impedance
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/032—Automatic limiting or abutting means, e.g. for safety pressure limiting, e.g. hydrostatic
Definitions
- This invention relates to an improved electrosurgical instrument and method for cauterization, coagulation and/or tissue welding in the performance of surgical procedures, especially endoscopic procedures.
- suturing was one of the primary means for providing hemostasis and joining tissue. Before other hemostatic and tissue repair means were introduced, surgeons had to spend a great deal of time sewing the tissue of patients back together.
- Surgical clips were introduced as a means to close off blood vessels, particularly when cutting highly vascularized tissue.
- Application of surgical clips can be cumbersome in certain procedures.
- the vessels must be identified.
- a clip must be individually applied on both sides of the intended cut of each identified vessel. Also, it may be difficult to find some vessels, particularly where the vessel is surrounded by fatty tissue.
- Surgical staplers have been effective in decreasing the amount of time it takes to fasten tissue together.
- Staplers have been used for tissue joining, and to provide hemostasis in conjunction with tissue cutting.
- Such devices include, for example, linear and circular cutting and stapling instruments.
- a linear cutter has parallel rows of staples with a slot for a cutting means to travel between the rows of staples.
- This type of surgical stapler secures tissue for improved cutting, joins layers of tissue, and provides hemostasis by applying parallel rows of staples to layers of surrounding tissue as the cutting means cuts between the parallel rows.
- These types of cutting and stapling devices have been used successfully in procedures involving fleshy tissue such as muscle or bowel, particularly in bowel resection procedures.
- Circular cutting and stapling devices have successfully been used, for example, in anastomotic procedures where a lumen is rejoined.
- the results with cutting and stapling devices have been less than optimum where the procedure involves cutting highly vascularized tissue, such as mesentery or adnexa, which are prone to having hemostasis problems.
- Electrocautery devices have also been used for effecting hemostasis.
- Monopolar devices utilize one electrode associated with a cutting or cauterizing instrument and a remote return electrode, usually adhered externally to the patient.
- bipolar instruments have been used because the cauterizing current is generally limited to tissue between two electrodes of the instrument.
- Bipolar forceps have been used for cutting and/or coagulation in various procedures.
- bipolar forceps have been used in sterilization procedures where the fallopian tubes are sealed off.
- bipolar forceps grasp tissue between two poles and apply electrical current through the grasped tissue.
- Bipolar forceps have certain drawbacks, some of which include the tendency of the current to arc between poles when tissue is thin or the forceps to short when the poles of the forceps touch.
- the use of forceps for coagulation is also very technique dependent and the forceps are not adapted to simultaneously cauterize a larger area of tissue.
- Bipolar scissors have been disclosed where two scissors blades act as two electrodes having insulated shearing surfaces. This device mechanically cuts tissue as coagulating electrical current is delivered to tissue in the current path. Bipolar scissors are also highly technique dependent in their use.
- One known method of varying the pressure applied to the tissue by the jaws of the end effector involves varying the gap between the jaws depending upon the tissue being grasped.
- Such an arrangement would necessitate the use of different instruments, different end effectors or different staple cartridges depending upon the tissue being grasped. It would, therefore, be advantageous to design an instrument wherein the pressure applied by the end effector would vary with the thickness and makeup of the tissue being grasped.
- Non electrosurgical endocutters such as those described in US Patent 5,597,107, employ a relatively stiff lower jaw member which includes a staple cartridge in conjunction with a more flexible upper member which acts as an anvil against which the staples are formed.
- the anvil is generally manufactured to be as stiff as possible, within the limits of size, materials and other design considerations and the spring rate of such an anvil may be, for example, in the range of 350-450 pounds per inch.
- Spring rate in terms of tissue compression forces in conventional staplers with gap spacing pins, is used in conjunction with the gap pin to create and maintain a minimum gap between the staple cartridge and the anvil, setting the height of the formed staple.
- the designers of conventional stapling instruments with gap spacing pins are primarily interested in the formation of a simple beam with consistent gap to form consistent staples.
- the gap pin is not used and the anvil is designed with sufficient stiffness to facilitate the formation of tissue. It would, therefore, be advantageous to design an electrosurgical instrument where the spring rate of the anvil is sufficiently stiff for the formation of staples while exerting a pressure in a range which facilitates the proper cauterization of tissue.
- Hemostasis is used herein to mean generally the arresting of bleeding including by coagulation, cauterization and/or tissue joining or welding.
- Another object of the invention is to provide an improved cutting and stapling device with an electrocautery means for tissue welding or cauterization along a cutting path wherein the device is adapted to grasp tissue and exert a pressure within a predetermined range in order to provide improved hemostasis prior to cutting the tissue.
- an electrosurgical device having an end effector with opposing interfacing surfaces associated with jaws for engaging tissue therebetween, and two electrically opposite poles located on one or both of the opposing surfaces.
- the poles are isolated from each other with an insulating material, or, where the poles are on opposite interfacing surfaces, they may be offset from each other so that they do not directly oppose each other on interfacing surfaces.
- an electrosurgical device according to the present invention includes a substantially fixed lower jaw.
- an electrosurgical device according to the present invention includes a substantially flexible upper jaw having a spring rate in the range of between approximately 200 pounds per inch and approximately 600 pounds per inch. More particularly, the spring rate of the upper jaw is approximately 275 pounds per inch.
- An electrosurgical instrument of a preferred embodiment compresses tissue to a pressure within a predetermined range in a compression zone between a first interfacing surface and a second interfacing surface and applies electrical energy through the compression zone.
- the first interfacing surface is comprised of: a first pole of a bipolar energy source, which interfaces with the compressed tissue in the compression zone; and a second pole electrically isolated from the first pole and located on the same or opposite interfacing surface. Electrically isolated poles are defined herein to mean electrodes isolated from each other by an insulating material in the end effector and/or offset from each other on opposing surfaces.
- the compression zone is an area defined by a compression ridge on one of the interfacing surfaces which compresses the tissue against the other interfacing surface. Also, there may be a compression ridge on both interfacing surfaces.
- a coagulation zone is defined by the first pole, the second pole, and an insulator insulating the first pole from the second pole. The second pole, located on one of the interfacing surfaces, is generally adjacent to the insulator on the same interfacing surface or across from the insulator on an opposing surface. This arrangement electrically isolates the two poles and enables the current path between the first and second poles to cross through a desired area of tissue.
- tissue compression normalizes tissue impedance by reducing structural differences in tissue which can cause impedance differences. Compression also stops significant blood flow and squeezes out blood which acts as a heat sink, particularly when flowing through blood vessels. Thus, compression optimizes delivery of energy to tissue in part by enabling the rate of energy delivery to exceed the rate of dissipation due to blood flow.
- the arrangement of the electrodes, which make up the poles, is important to ensure that the current passing between the two poles passes though the compression zone. Also, insulation or isolation of the opposite poles from each other on the instrument permits tissue compression without shorting of the instrument poles or electrical arcing common in bipolar instruments.
- the pressure initially applied to tissue in the compression zone is between approximately 30 pounds per square inch (psi) and approximately 250 psi. In a further embodiment of the present invention, the pressure initially applied to tissue in the compression zone is between approximately 75 psi and 250 psi. In a further embodiment of the present invention, the pressure initially applied to tissue in the compression zone is between approximately 115 psi and 185 psi.
- tissue compression and the arrangement of the electrodes permit more efficient cauterization and offer the advantage of achieving hemostasis in a wide range of tissue impedance, thickness and vascularity.
- the first pole is located on a first interfacing surface of a first jaw and the second pole is located on the same jaw as the first pole, but not on the interfacing surface.
- the present invention also provides a device capable of coagulating a line or path of tissue along or lateral to a cut line or a cutting path.
- the first pole comprises an elongated electrode.
- the elongated electrode along with the adjacent insulator form a ridge to compress the tissue to be cauterized.
- the second pole is adjacent the insulator on an opposite side of the insulator from the first pole.
- a cutting means for cutting tissue is incorporated into the device and the device provides hemostatic lines adjacent to the path of the cutting means.
- cutting may occur at anytime either before, during or after cauterization or welding.
- stapling means is provided on one or both sides of the cutting path.
- an indicator means communicates to the user that the tissue has been cauterized to a desired or predetermined degree.
- the coagulation is completed prior to any mechanical cutting, i.e., actuation of the cutting means. If an indicator means is used, once tissue is cauterized, the cutting means may be actuated to cut between the parallel bars while the rows of staples are applied to the tissue.
- the hemostatic device is incorporated into a linear cutter similar to a linear cutting mechanical stapler.
- the hemostatic device comprises two parallel and joined elongated electrode bars which form one pole, and a slot for a cutting means to travel between the bars.
- one or more rows of staples may be provided on each side of the slot and bars to provide additional hemostasis.
- tissue is clamped between two jaws. Electrical energy in the form of radio frequency current is applied to the compressed tissue to cauterize the blood vessels along the two parallel bars.
- Another embodiment provides a means for detecting abnormal impedance or other electrical parameters which are out of a predetermined range.
- the means for detecting may be used to indicate when the instrument has been applied to tissue exhibiting impedance out of range for anticipated good coagulation. It may also be used for detecting other instrument abnormalities. It is possible to detect the abnormal condition, for example, by using comparisons of normal ranges of initial tissue impedance in the interface electronics. This could be sensed in the first few milliseconds of the application of RF energy and would not present a significant therapeutic dose of energy.
- a warning mechanism may be used to warn the user when the impedance is out of range. Upon repositioning of the instrument, the same measurement criteria would apply and if the tissue impedance was again out of range, the user would again be warned. This process would continue until the normal impedance range was satisfied and good coagulation could be anticipated.
- FIG. 1 Another embodiment provides a tissue welding and cauterizing cutting device similar to an intraluminal stapler.
- the poles are formed in two concentric circle electrodes separated by an insulator.
- the electrodes which make up the poles may be located on either the stapler cartridge or the anvil.
- FIG. 1-9 there is illustrated a preferred embodiment of the present invention.
- An endoscopic electrocautery linear cutting and stapling instrument 10 is shown having a body 16 coupled to a shaft 30 with a lumen extending therethrough and an end effector 50 extending from the distal end 21 of the shaft 30.
- the shaft 30 is formed of an insulative material and has an electrically conductive sheath 38 extending through its lumen.
- a channel 39 extending through the sheath 38 guides co-axial movement of a driver means 44 within the channel 39.
- the driver means 44 includes a firing trigger 14 associated with the body 16, coupled to a flexible firing rod 40 coupled to a driving rod 41, coupled to a block 43.
- the block 43 is coupled to a cutting means 11 and a staple driving wedge 13, which the driving means 44 advances by way of the block 43 into the end effector 50.
- the end effector 50 comprises two interfacing jaw members 32, 34.
- the end effector 50 is secured by way of jaw member 34 to the channel 39.
- the jaw member 32 is movably secured to jaw member 34.
- the body 16 has a clamping trigger 12 for closing the jaws 32, 34 which longitudinally advances a close rack 45 coupled to the proximal end of the sheath 38.
- the close rack 45 advances the sheath 38 co-axially through the shaft 30.
- the sheath 38 advances over a camming surface 27 of jaw 32 to close the jaws 32 and 34 onto tissue situated between the jaws.
- the close rack 45 also acts as a switch to close the circuit which communicates electrical energy to the end effector 50.
- Jaw member 32 comprises an anvil 18, a U-shaped first pole 52 extending longitudinally with respect to the jaw 32, and a U-shaped insulating material 55 surrounding the outside of the first pole 52.
- Jaw member 32 has an inner surface 33 which faces an inner surface 35 of jaw 34.
- the inner surface 33 includes first pole 52 which comprises two electrically communicating electrode bars 53, 54 comprised of stainless steel or aluminum, extending substantially along the length of the inner surface 33.
- the bars 53, 54 are separated by a knife channel 42 extending longitudinally through the first pole's center to form its U-shape.
- the surface of the bars are formed in flat strips to provide more surface area contact with tissue.
- Two series of pockets 36, 37 located on anvil 18, for receiving staple ends, extend along the inner surface 33, lateral to and outside of bars 53, 54 respectively.
- the electrode bars 53, 54 and the insulating material 55 form a ridge 56 extending out relative to the anvil portion 33a of the inner surface 33 ( Figure 6).
- the anvil 18 is formed of an electrically conductive material and acts as a second pole electrically opposite to the first pole.
- the anvil 18 is isolated from the first pole 52 by the U-shaped insulating material 55.
- Jaw member 34 comprises a cartridge channel 22 and a cartridge 23.
- the cartridge 23 includes a track 25 for the wedge 13, knife channel 26 extending longitudinally through the center of the cartridge 23, a series of drivers 24 extending into track 25 and staples 100 arranged in two sets of parallel double rows.
- the driver means 44 may be actuated or fired using trigger 14 to advance the cutting means 11 and wedge 13 through the engaged tissue to staple and cut the tissue.
- the firing mechanism 14 is actuated, the wedge 13 is advanced through the track 25 causing the drivers 24 to displace towards the staples 100, thereby driving the staples 100 through tissue and into anvil pockets 36, 37.
- dimension B which is measured from inner surface 33 of jaw member 32 to tissue surface 80 of U-shaped insulating material 55, is preferably in the range of from approximately 0.0 inches to approximately 0.045 inches and preferably approximately 0.0 inches.
- Dimension C which is measured from inner edge 82 to outer edge 84 of U-shaped insulator 55 along tissue surface 80, is preferably in the range of from approximately 0.01 inches to approximately 0.04 inches and preferably approximately 0.02 inches.
- Dimension E which is measured from inner edge 86 to outer edge 88 of first pole 52 as measured along tissue surface 90, is preferably in the range of from approximately .002 inches to .04 inches and preferably approximately .020 inches.
- Dimension G which is measured from tissue surface 90 to tissue surface 92 with jaws 32 and 34 closed, is preferably in the range from approximately 0.0 inches to approximately 0.020 inches and preferably approximately 0.001 inches. Dimension G is measured without tissue engaged.
- a knob 15 located on the distal end of the body 16 rotates the shaft 30, sheath 38, channel 39 and end effector 50 which are directly or indirectly coupled to the knob 15 so that the knob 15 may be used for rotational placement of the end effector jaws 32,34.
- Bipolar energy is supplied to the end effector 50 from an electrosurgical generator 60 through wires 19, 20 extending into the body 16 of the instrument.
- the generator 60 is user controlled by way of a footswitch 65.
- Wire 19 which provides electrical current to the first pole, is coupled through a wire or other electrical contact means 61 to electrical contact 62, associated with the first pole, located on the distal end of close rack 45.
- Wire 20 which carries the current of the opposite pole, is coupled through a wire or other electrical contact means 66 to a disc contact 67 located at the distal end of the close rack 45 and electrically isolated from contact 62.
- a disc contact 63, associated with the first pole, located at the distal end of the body 16 is in electrical communication with a wire or other contact means 64.
- Contact means 64 extends through channel 39 to end effector jaw 32 where it contacts first pole 52.
- the disc contact 63 permits the knob 15 to rotate while contact is maintained between the disc contact 63 and the contact means 64.
- the contact means 64 is electrically insulated from the sheath 38.
- the close rack 45 moves distally so that the contact 62 comes in electrical communication with the disc contact 63 and the disc contact 67, associated with the second pole 51, comes in electrical contact with the electrically conductive sheath 38.
- the sheath 38 moves over the camming surface 27 of the electrically conductive anvil 18 which acts as the return electrode.
- the electrical circuit is closed when and only when the clamping trigger 12 is closed.
- the end effector 50 of the instrument is located at a tissue site where tissue is to be cut.
- the jaw members 32, 34 are opened by pressing a release button 70 which releases a button spring 71 and permits the close rack 45 to move proximally.
- Tissue is then placed between the interfacing inner surfaces 33, 35 respectively of the jaw members 32, 34.
- the clamping trigger 12 is squeezed to cause the sheath 38 to move over the camming surface 27 and thereby close the jaws 32, 34 and simultaneously close the electrical circuit as described above.
- the electrode bars 53, 54 and the insulating material 55 which together form the ridge 56, compress the tissue against the inner surface 35 of jaw member 34.
- a user then applies RF energy from the generator 60 using the footswitch 65 or other switch. Current flows through the compressed tissue between the first pole 52, i.e. the bars 53, 54, and the second pole 51, i.e., the anvil 18.
- the initial pressure applied to compress the tissue in the compression zone is between approximately 30 pounds per square inch (psi) and 250 psi. More particularly, in a further embodiment of the present invention the initial pressure applied to compress the tissue in the compression zone is between approximately 75 psi and 250 psi. More particularly in a further embodiment of the present invention the initial pressure applied to compress the tissue in the compression zone is between approximately 75 psi and 175 psi. In one embodiment of the present invention, the initial pressure applied to compress tissue positioned between the jaws is approximately 125 psi. With sufficient pressure applied fluid, including blood, is forced out of the tissue in the compression zone, facilitating coagulation. In addition, pressure applied to tissue within the compression zone facilitates coupling of electrosurgical energy to the tissue by forcing the tissue against the electrode.
- the pressure exerted by the anvil is a function of the spring rate of the anvil.
- a pre-bend angle By providing a "pre-bend" angle on the anvil it is possible to obtain a pre-load (at a zero gap.)
- the anvil may be viewed as a prestressed beam.
- a Preferred value of preload is in the range of between 12 and 18 pounds with a preferred value of approximately 15 pounds.
- the spring rate of the anvil is more accurately a function of the stiffness of the "system", where the system includes the anvil, channel, cartridge, tube, etc.
- Each of the elements of the system has a particular spring rate and each may be suitably modified to increase the stiffness of the system.
- the spring rate of jaw 32 is between approximately 225 pounds per inch and approximately 350 pounds per inch. More particularly, the spring rate of anvil 18 on jaw 32 is preferably in the range of approximately 275 pounds per inch.
- the bipolar energy source is a low impedance source providing radio frequency energy from about 300 kHz to 3 MHZ.
- the current delivered to the tissue is from 0.1 to 1.5 amps and the voltage is from 30 to 200 volts RMS.
- An audible, visible, tactile, or other feedback system may be used to indicate when sufficient cauterization has occurred at which point the RF energy may be turned off.
- An example of such a feedback system is described below.
- the cutting means 11 is advanced and the staples 100 are fired using the firing trigger 14. Firing is accomplished by rotating the firing trigger 14 acting as a lever arm about pivot 14a.
- the driver means 44 advances the cutting means 11 and wedge 13.
- the cutting means 11 cuts the tissue in between the bars 53, 54 where the tissue has been cauterized. Thus, the cut line is lateral to the coagulation lines formed by the bar electrodes.
- the wedge 13 simultaneously advances the drivers 24 into the staples 100 causing the staples 100 to fire through tissue and into the pockets 36, 37 of the anvil 18. Staples 100 are applied in two longitudinal double rows on each side of the cutting means 11 as the cutting means cuts the tissue.
- the cartridge provides multifire stapling capabilities by replacing the double row of staples with a single row.
- a single shot replaceable cartridge is used.
- this type of stapler was designed to provide a double row of staples for each parallel row. Because of the size of the space necessary to contain the double row of staples, a refireable cartridge with stacked staples has not been preferred because of the additional space required for stacking staples.
- a single row of staples is used. Using a single row of staples permits stacking of staples in the space previously occupied by the second row of staples, providing multifire capabilities.
- no staples are required and the electrical current lines provide the necessary hemostasis.
- a preferred embodiment of the present invention includes a feedback system designed to indicate when a desired or predetermined degree of coagulation has occurred. This is particularly useful where the coagulation zone is not visible to the user.
- the feedback system measures electrical parameters of the system which include coagulation level.
- the feedback system may also determine tissue characteristics at or near a coagulation zone which indicate degree of coagulation.
- the electrical impedance of the tissue to which the electrical energy is applied may also be used to indicate coagulation. Generally, as energy is applied to the tissue, the impedance will initially decrease and then rise as coagulation occurs. An example of the relationship between electrical tissue impedance over time and coagulation is described in Vaellfors, Bertil and Bergdahl, Bjoern "Automatically controlled Bipolar Electrocoagulation,” Neurosurg. Rev. p. 187-190 (1984) incorporated herein by reference. Also as desiccation occurs, impedance increases. tissue carbonization and or sticking to instrument as a result of over application of high voltage may be prevented using a feedback system based on tissue impedance characteristics. Other examples of tissue characteristics which may indicate coagulation include temperature and light reflectance.
- a flow chart illustrates a feedback system which is implemented in a preferred embodiment of the present invention.
- energy is applied to the tissue.
- the system current and voltage applied to the tissue is determined.
- the impedance value is calculated and stored.
- a function of the impedance for example, which may include the impedance, the change in impedance, and/or the rate of change in impedance, it is determined whether desired coagulation has occurred. If coagulation has occurred to a predetermined or desired degree, an indication means indicates that the energy should be turned off. Such an indication means may include a visible light, an audible sound or a tactile indicator.
- the feedback means may also control the generator and turn the energy off at a certain impedance level.
- An alternative embodiment provides a continuous audible sound in which the tone varies depending on the impedance level.
- An additional feature provides an error indication means for indicating an error or instrument malfunction when the impedance is below a normal minimum and/ or above a maximum range.
- Figures 11-14 illustrate alternative configurations of an end effector.
- the first pole 152 and the second pole 151 are both located on the same jaw 132 having the anvil 118.
- the U-shaped first pole 152 forms the knife channel 142.
- a U-shaped insulator 155 surrounds the first pole 152 except on the surface 133 so that it is electrically isolated from the second pole 151.
- the compression ridge 156 is formed on the cartridge which is made from an electrically non-conductive material. The ridge 156 compresses tissue against the first pole 152 and insulator 155 to form a tissue compression zone.
- first pole 252 and the second pole 251 are both located on the same jaw 232 having the anvil 218.
- the first pole 252 and the second pole 251 each are located on opposing sides of the knife channel 242.
- An insulator 255 surrounds the poles 251, 252 except on the surface 233 so that the poles 251, 252 are electrically isolated from each other.
- the compression ridge 256 is formed on the cartridge which is made from an electrically non-conductive material. The ridge 256 compresses tissue against the poles 251, 252 and insulator 255 to form a tissue compression zone.
- second pole 351 is located on the jaw 332 having the anvil 318 while the first pole 352 is located on the cartridge 323.
- the U-shaped first pole 352 forms the knife channel 326 and is surrounded by insulator 355a.
- a U-shaped insulator 355b forms the knife channel 342 in jaw 332.
- the jaw is formed of an electrically conductive material which makes up the second pole 351.
- the first pole 352 and the insulator 355a form the compression ridge 356 which compresses tissue against the surface 333 of jaw 332 to form a compression zone.
- the insulator 355b is of sufficient width that it prevents poles 351, 352 form contacting when the jaws 332,334 are closed.
- the first pole 452 and the second pole 451 are both located on the jaw 434 having the cartridge 423.
- the first pole 452 and the second pole 451 each are located on opposing sides, forming the knife channel 426 through the cartridge 423.
- An insulator 455a surrounds the poles 451, 452 except on the surface 435, so that the poles 451, 452 are electrically isolated from each other.
- the compression ridge 456 is formed on the cartridge 423 and forms a compression zone by compressing tissue against an insulator 455b disposed on the surface 433 of the jaw 432.
- Figure 15 illustrates an alternative embodiment.
- the first and second poles 551, 552 and knife channel 542 are arranged in a similar configuration as in Figure 12 except that the first and second poles 551 and 552 each comprise a series of electrically connected electrodes staggered along the length of the knife channel with insulating material in between staggered electrodes.
- Figure 16 illustrates staggered electrodes as in Fig 15 but with first pole electrodes 652 and second pole electrodes 651 alternating along the length of the knife channel 642 and on each side of the knife channel 642.
- Figs. 17 and 18 illustrate another embodiment in which first and second poles 751, 752 each comprise staggered electrodes.
- the first pole 752 is staggered along each side of the knife channel 126 and located on the compression ridge 756 formed on the cartridge 723.
- the second pole 751 is staggered along each side of the knife channel 742 on the surface 733 of jaw 732.
- the poles 751, 752 are vertically aligned, but as illustrated in Figure 17, are staggered so that when the jaws 732, 734 are closed, the poles are electrically isolated from each other by insulators 755a, 755b.
- Figure 19 illustrates an alternative embodiment of the end effector.
- the first pole 852 and the second pole 851 are both located on the jaw 832 having an anvil 818.
- the first pole 852 forms the ridge 856 for compressing tissue in a compression zone and is located on interfacing surface 833.
- the second pole 851 is located on the side of the anvil 818 and not on interfacing surface 833.
- FIGs. 20 and 21 illustrate a circular cutter of the present invention with stapling means.
- Figure 20 illustrates the stapler cartridge 900 with an interfacing surface 933.
- a double row of staple apertures 901 through which staples are driven into tissue are staggered about the outer circumference of the surface 932.
- a first pole 952 encircles the inner circumference of the surface 933.
- An insulator 955 electrically isolates the first pole 952 from the portion 933a of the surface 933 surrounding the staple apertures.
- the staple aperture portion 933a is formed of an electrically conductive material and acts as a second pole.
- a circular cutting knife 911 is recessed within the cartridge 900 radially inward from the inner circumference of the surface 933.
- Figure 21 illustrates an anvil 918 with pockets 937 for receiving staples and a compression ridge 956 for compressing tissue against the first pole 952 and insulator 955 of the cartridge.
- the circular cutter is operated similarly to the circular stapler described in U.S. Patent No. 5,104,025 incorporated herein by reference.
- tissue welding electrical current may be delivered between the first pole 952 and the staple aperture portion 933a to tissue.
- the circular cutter may be used without staples. Electrical current is delivered through the poles to weld and coagulate tissue, then the knife may be advanced to cut tissue in a procedure such as an anastomosis.
- the jaws of the instrument for example, jaws 32 and 34 of end effector 50, are closed around the tissue which is to be treated. Tissue trapped between the instrument jaws is compressed as described herein
- An electrosurgical instrument according to the present invention is beneficial in that coagulation of tissue is enhanced since the pressures applied force fluid out of the coagulation region without tearing the tissue.
- the pressure ranges specified herein are also beneficial in that, using an instrument according to the present invention, contact between the tissue and electrodes is improved, coagulation is improved throughout the tissue and charring is reduced.
Abstract
An electrosurgical instrument is provided for cauterization and/or welding of
tissue of varying impedance, thickness and vascularity especially in the performance of
endoscopic procedures. The instrument compresses the tissue between one pole of a
bipolar energy source located on one interfacing surface, and a second interfacing
surface applying pressure in a predetermined range. A second pole is located one of
the two interfacing surfaces. In a preferred embodiment, the second pole is located on
the same interfacing surface as the first pole and an insulator electrically isolates the
two poles. A preferred application of the invention is in a cutting instrument wherein
a hemostatic line is formed along a cut line using RF energy.
Description
This invention relates to an improved electrosurgical instrument and method
for cauterization, coagulation and/or tissue welding in the performance of surgical
procedures, especially endoscopic procedures.
Surgical procedures requiring cutting of tissue can cause bleeding at the site of
the cutting. Before surgeons had the means to control bleeding many surgical
procedures were quite difficult to perform because of excessive blood loss.
Hemostasis is even more crucial in endoscopic or laparoscopic surgery where if the
bleeding is not kept under control, the laparoscopy must be abandoned and the
patient's body cut to perform open surgery so that inaccessible bleeding may be
controlled.
Thus, various techniques have been adapted to control bleeding with varying
degrees of success such as, for example, suturing, applying clips to blood vessels, and
stapling, as well as electrocautery and other thermogenic techniques. Advances in
tissue joining, tissue repair and wound closure also have permitted surgical procedures
previously not possible or too risky.
Initially, suturing was one of the primary means for providing hemostasis and
joining tissue. Before other hemostatic and tissue repair means were introduced,
surgeons had to spend a great deal of time sewing the tissue of patients back together.
Surgical clips were introduced as a means to close off blood vessels,
particularly when cutting highly vascularized tissue. Application of surgical clips,
however, can be cumbersome in certain procedures. The vessels must be identified.
Then a clip must be individually applied on both sides of the intended cut of each
identified vessel. Also, it may be difficult to find some vessels, particularly where the
vessel is surrounded by fatty tissue.
Surgical staplers have been effective in decreasing the amount of time it takes
to fasten tissue together. There are various types of surgical staplers. Staplers have
been used for tissue joining, and to provide hemostasis in conjunction with tissue
cutting. Such devices include, for example, linear and circular cutting and stapling
instruments. Typically, a linear cutter has parallel rows of staples with a slot for a
cutting means to travel between the rows of staples. This type of surgical stapler
secures tissue for improved cutting, joins layers of tissue, and provides hemostasis by
applying parallel rows of staples to layers of surrounding tissue as the cutting means
cuts between the parallel rows. These types of cutting and stapling devices have been
used successfully in procedures involving fleshy tissue such as muscle or bowel,
particularly in bowel resection procedures. Circular cutting and stapling devices have
successfully been used, for example, in anastomotic procedures where a lumen is
rejoined. However, the results with cutting and stapling devices have been less than
optimum where the procedure involves cutting highly vascularized tissue, such as
mesentery or adnexa, which are prone to having hemostasis problems.
Electrocautery devices have also been used for effecting hemostasis.
Monopolar devices utilize one electrode associated with a cutting or cauterizing
instrument and a remote return electrode, usually adhered externally to the patient.
More recently, bipolar instruments have been used because the cauterizing current is
generally limited to tissue between two electrodes of the instrument.
Bipolar forceps have been used for cutting and/or coagulation in various
procedures. For example, bipolar forceps have been used in sterilization procedures
where the fallopian tubes are sealed off. Generally, bipolar forceps grasp tissue
between two poles and apply electrical current through the grasped tissue. Bipolar
forceps, however, have certain drawbacks, some of which include the tendency of the
current to arc between poles when tissue is thin or the forceps to short when the poles
of the forceps touch. The use of forceps for coagulation is also very technique
dependent and the forceps are not adapted to simultaneously cauterize a larger area of
tissue.
Bipolar scissors have been disclosed where two scissors blades act as two
electrodes having insulated shearing surfaces. This device mechanically cuts tissue as
coagulating electrical current is delivered to tissue in the current path. Bipolar scissors
are also highly technique dependent in their use.
In prior devices, such as the device described in US Patent 5,403,312,
electrosurgical energy has been delivered to biologic tissue in order to create a region
of coagulation, as, for example, on either side of an incision, thus preventing blood
and other bodily fluids from leaking out of the incision. In such a device, if tissue
grasped by the jaws is compressed too much by applying excessive pressure to the
region of coagulation, the tissue grasped by the end effector may be tom or crushed.
If the tissue is not compressed enough because to little pressure is applied to the region
of coagulation, the tissue in the region of coagulation may not be not effectively or
uniformly cauterized because fluid (e.g. blood) could remain in the region of
cauterization. In prior art devices, the surgeon has used tactile feedback and visual
clues to determine the amount of pressure to apply to the region in order to obtain
optimum coagulation. In instruments wherein the region of coagulation is partially or
fully obscured, either by the end effector or by tissue, and is, therefore, not visible to
the surgeon, it is particularly difficult for the surgeon to ensure that the appropriate
pressure is being applied by the end effectors to ensure proper coagulation. It would,
therefore, be advantageous to develop an electrosurgical instrument wherein the
surgeon is not required to adjust the pressure applied by the end effector prior to
applying electrosurgical energy to tissue in the region of coagulation. It would further
be advantageous to design an instrument wherein the pressure applied to the tissue
prior to coagulation is within a predetermined range.
One known method of varying the pressure applied to the tissue by the jaws of
the end effector involves varying the gap between the jaws depending upon the tissue
being grasped. However, such an arrangement would necessitate the use of different
instruments, different end effectors or different staple cartridges depending upon the
tissue being grasped. It would, therefore, be advantageous to design an instrument
wherein the pressure applied by the end effector would vary with the thickness and
makeup of the tissue being grasped.
Non electrosurgical endocutters such as those described in US Patent
5,597,107, employ a relatively stiff lower jaw member which includes a staple
cartridge in conjunction with a more flexible upper member which acts as an anvil
against which the staples are formed. In such instruments, the anvil is generally
manufactured to be as stiff as possible, within the limits of size, materials and other
design considerations and the spring rate of such an anvil may be, for example, in the
range of 350-450 pounds per inch. A stiff anvil helps to ensure that the staples form
properly when the instrument is fired. Spring rate, in terms of tissue compression
forces in conventional staplers with gap spacing pins, is used in conjunction with the
gap pin to create and maintain a minimum gap between the staple cartridge and the
anvil, setting the height of the formed staple. Therefore, the designers of conventional
stapling instruments with gap spacing pins are primarily interested in the formation of
a simple beam with consistent gap to form consistent staples. In other designs, the gap
pin is not used and the anvil is designed with sufficient stiffness to facilitate the
formation of tissue. It would, therefore, be advantageous to design an electrosurgical
instrument where the spring rate of the anvil is sufficiently stiff for the formation of
staples while exerting a pressure in a range which facilitates the proper cauterization of
tissue.
It is therefore an object of the present invention to provide a hemostatic
electrosurgical instrument which can exert pressure in a range to efficiently provide
improved hemostasis in multiple tissue types and thickness, e.g., in fleshy or vascular
tissue areas, and high, low or combination impedance tissues. Hemostasis is used
herein to mean generally the arresting of bleeding including by coagulation,
cauterization and/or tissue joining or welding.
Another object of the invention is to provide an improved cutting and stapling
device with an electrocautery means for tissue welding or cauterization along a cutting
path wherein the device is adapted to grasp tissue and exert a pressure within a
predetermined range in order to provide improved hemostasis prior to cutting the
tissue.
These and other objects of the invention are described in an electrosurgical
device having an end effector with opposing interfacing surfaces associated with jaws
for engaging tissue therebetween, and two electrically opposite poles located on one or
both of the opposing surfaces. The poles are isolated from each other with an
insulating material, or, where the poles are on opposite interfacing surfaces, they may
be offset from each other so that they do not directly oppose each other on interfacing
surfaces. In particular, an electrosurgical device according to the present invention
includes a substantially fixed lower jaw. Further, an electrosurgical device according
to the present invention includes a substantially flexible upper jaw having a spring rate
in the range of between approximately 200 pounds per inch and approximately 600
pounds per inch. More particularly, the spring rate of the upper jaw is approximately
275 pounds per inch.
An electrosurgical instrument of a preferred embodiment compresses tissue to
a pressure within a predetermined range in a compression zone between a first
interfacing surface and a second interfacing surface and applies electrical energy
through the compression zone. The first interfacing surface is comprised of: a first
pole of a bipolar energy source, which interfaces with the compressed tissue in the
compression zone; and a second pole electrically isolated from the first pole and
located on the same or opposite interfacing surface. Electrically isolated poles are
defined herein to mean electrodes isolated from each other by an insulating material in
the end effector and/or offset from each other on opposing surfaces.
In a preferred embodiment, the compression zone is an area defined by a
compression ridge on one of the interfacing surfaces which compresses the tissue
against the other interfacing surface. Also, there may be a compression ridge on both
interfacing surfaces. A coagulation zone is defined by the first pole, the second pole,
and an insulator insulating the first pole from the second pole. The second pole,
located on one of the interfacing surfaces, is generally adjacent to the insulator on the
same interfacing surface or across from the insulator on an opposing surface. This
arrangement electrically isolates the two poles and enables the current path between the
first and second poles to cross through a desired area of tissue.
It is believed that the tissue compression normalizes tissue impedance by
reducing structural differences in tissue which can cause impedance differences.
Compression also stops significant blood flow and squeezes out blood which acts as a
heat sink, particularly when flowing through blood vessels. Thus, compression
optimizes delivery of energy to tissue in part by enabling the rate of energy delivery to
exceed the rate of dissipation due to blood flow. The arrangement of the electrodes,
which make up the poles, is important to ensure that the current passing between the
two poles passes though the compression zone. Also, insulation or isolation of the
opposite poles from each other on the instrument permits tissue compression without
shorting of the instrument poles or electrical arcing common in bipolar instruments.
In one embodiment of the present invention, the pressure initially applied to
tissue in the compression zone is between approximately 30 pounds per square inch
(psi) and approximately 250 psi. In a further embodiment of the present invention, the
pressure initially applied to tissue in the compression zone is between approximately
75 psi and 250 psi. In a further embodiment of the present invention, the pressure
initially applied to tissue in the compression zone is between approximately 115 psi
and 185 psi.
Thus, the tissue compression and the arrangement of the electrodes permit
more efficient cauterization and offer the advantage of achieving hemostasis in a wide
range of tissue impedance, thickness and vascularity.
In an alternative embodiment of the invention, the first pole is located on a first
interfacing surface of a first jaw and the second pole is located on the same jaw as the
first pole, but not on the interfacing surface.
The present invention also provides a device capable of coagulating a line or
path of tissue along or lateral to a cut line or a cutting path. In one embodiment, the
first pole comprises an elongated electrode. The elongated electrode along with the
adjacent insulator form a ridge to compress the tissue to be cauterized. The second
pole is adjacent the insulator on an opposite side of the insulator from the first pole.
In one preferred embodiment, a cutting means for cutting tissue is incorporated
into the device and the device provides hemostatic lines adjacent to the path of the
cutting means. Of course, cutting may occur at anytime either before, during or after
cauterization or welding. In one variation of this preferred embodiment, stapling
means is provided on one or both sides of the cutting path.
In one embodiment, an indicator means communicates to the user that the
tissue has been cauterized to a desired or predetermined degree.
In another embodiment, the coagulation is completed prior to any mechanical
cutting, i.e., actuation of the cutting means. If an indicator means is used, once tissue
is cauterized, the cutting means may be actuated to cut between the parallel bars while
the rows of staples are applied to the tissue.
In another embodiment, the hemostatic device is incorporated into a linear
cutter similar to a linear cutting mechanical stapler. In this embodiment the hemostatic
device comprises two parallel and joined elongated electrode bars which form one
pole, and a slot for a cutting means to travel between the bars. Optionally, one or
more rows of staples may be provided on each side of the slot and bars to provide
additional hemostasis. In operation, tissue is clamped between two jaws. Electrical
energy in the form of radio frequency current is applied to the compressed tissue to
cauterize the blood vessels along the two parallel bars.
Another embodiment provides a means for detecting abnormal impedance or
other electrical parameters which are out of a predetermined range. For example, the
means for detecting may be used to indicate when the instrument has been applied to
tissue exhibiting impedance out of range for anticipated good coagulation. It may also
be used for detecting other instrument abnormalities. It is possible to detect the
abnormal condition, for example, by using comparisons of normal ranges of initial
tissue impedance in the interface electronics. This could be sensed in the first few
milliseconds of the application of RF energy and would not present a significant
therapeutic dose of energy. A warning mechanism may be used to warn the user
when the impedance is out of range. Upon repositioning of the instrument, the same
measurement criteria would apply and if the tissue impedance was again out of range,
the user would again be warned. This process would continue until the normal
impedance range was satisfied and good coagulation could be anticipated.
Similarly another embodiment provides a tissue welding and cauterizing
cutting device similar to an intraluminal stapler. Preferably, the poles are formed in
two concentric circle electrodes separated by an insulator. The electrodes which make
up the poles may be located on either the stapler cartridge or the anvil.
These and other objects of the invention will be better understood from the
following attached Detailed Description of the Drawings, when taken in conjunction
with the Detailed Description of the invention.
Referring now to Figs. 1-9, there is illustrated a preferred embodiment of the
present invention. An endoscopic electrocautery linear cutting and stapling instrument
10 is shown having a body 16 coupled to a shaft 30 with a lumen extending
therethrough and an end effector 50 extending from the distal end 21 of the shaft 30.
The shaft 30 is formed of an insulative material and has an electrically conductive
sheath 38 extending through its lumen. A channel 39 extending through the sheath 38
guides co-axial movement of a driver means 44 within the channel 39. In this
particular embodiment, the driver means 44 includes a firing trigger 14 associated with
the body 16, coupled to a flexible firing rod 40 coupled to a driving rod 41, coupled to
a block 43. The block 43 is coupled to a cutting means 11 and a staple driving wedge
13, which the driving means 44 advances by way of the block 43 into the end effector
50.
The end effector 50 comprises two interfacing jaw members 32, 34. The end
effector 50 is secured by way of jaw member 34 to the channel 39. The jaw member
32 is movably secured to jaw member 34. The body 16 has a clamping trigger 12 for
closing the jaws 32, 34 which longitudinally advances a close rack 45 coupled to the
proximal end of the sheath 38. The close rack 45 advances the sheath 38 co-axially
through the shaft 30. The sheath 38 advances over a camming surface 27 of jaw 32 to
close the jaws 32 and 34 onto tissue situated between the jaws. As described in more
detail below, the close rack 45 also acts as a switch to close the circuit which
communicates electrical energy to the end effector 50.
Referring now to Figs. 3-9 and 22 an enlargement of the end effector 50 of the
instrument 10 is illustrated. The jaw members 32 and 34 are shown in an unclamped
position in Figure 3, in a clamped, unfired position in Figure 4 and in a clamped, fired
position in Figure 5. Jaw member 32 comprises an anvil 18, a U-shaped first pole 52
extending longitudinally with respect to the jaw 32, and a U-shaped insulating material
55 surrounding the outside of the first pole 52. Jaw member 32 has an inner surface 33
which faces an inner surface 35 of jaw 34. The inner surface 33 includes first pole 52
which comprises two electrically communicating electrode bars 53, 54 comprised of
stainless steel or aluminum, extending substantially along the length of the inner
surface 33. The bars 53, 54 are separated by a knife channel 42 extending
longitudinally through the first pole's center to form its U-shape. The surface of the
bars are formed in flat strips to provide more surface area contact with tissue. Two
series of pockets 36, 37 located on anvil 18, for receiving staple ends, extend along the
inner surface 33, lateral to and outside of bars 53, 54 respectively. The electrode bars
53, 54 and the insulating material 55 form a ridge 56 extending out relative to the
anvil portion 33a of the inner surface 33 (Figure 6). The anvil 18 is formed of an
electrically conductive material and acts as a second pole electrically opposite to the
first pole. The anvil 18 is isolated from the first pole 52 by the U-shaped insulating
material 55.
In the embodiment of the invention illustrated in Figure 22, dimension B,
which is measured from inner surface 33 of jaw member 32 to tissue surface 80 of U-shaped
insulating material 55, is preferably in the range of from approximately 0.0
inches to approximately 0.045 inches and preferably approximately 0.0 inches.
Dimension C, which is measured from inner edge 82 to outer edge 84 of U-shaped
insulator 55 along tissue surface 80, is preferably in the range of from approximately
0.01 inches to approximately 0.04 inches and preferably approximately 0.02 inches.
Dimension E, which is measured from inner edge 86 to outer edge 88 of first pole 52
as measured along tissue surface 90, is preferably in the range of from approximately
.002 inches to .04 inches and preferably approximately .020 inches. Dimension G,
which is measured from tissue surface 90 to tissue surface 92 with jaws 32 and 34
closed, is preferably in the range from approximately 0.0 inches to approximately
0.020 inches and preferably approximately 0.001 inches. Dimension G is measured
without tissue engaged.
A knob 15 located on the distal end of the body 16 rotates the shaft 30, sheath
38, channel 39 and end effector 50 which are directly or indirectly coupled to the knob
15 so that the knob 15 may be used for rotational placement of the end effector jaws
32,34.
Bipolar energy is supplied to the end effector 50 from an electrosurgical
generator 60 through wires 19, 20 extending into the body 16 of the instrument. The
generator 60 is user controlled by way of a footswitch 65.
A disc contact 63, associated with the first pole, located at the distal end of the
body 16 is in electrical communication with a wire or other contact means 64. Contact
means 64 extends through channel 39 to end effector jaw 32 where it contacts first
pole 52. The disc contact 63 permits the knob 15 to rotate while contact is maintained
between the disc contact 63 and the contact means 64. The contact means 64 is
electrically insulated from the sheath 38.
When the clamping trigger 12 is actuated, the close rack 45 moves distally so
that the contact 62 comes in electrical communication with the disc contact 63 and the
disc contact 67, associated with the second pole 51, comes in electrical contact with
the electrically conductive sheath 38. The sheath 38 moves over the camming surface
27 of the electrically conductive anvil 18 which acts as the return electrode. Thus the
electrical circuit is closed when and only when the clamping trigger 12 is closed.
In operation, the end effector 50 of the instrument is located at a tissue site
where tissue is to be cut. The jaw members 32, 34 are opened by pressing a release
button 70 which releases a button spring 71 and permits the close rack 45 to move
proximally. Tissue is then placed between the interfacing inner surfaces 33, 35
respectively of the jaw members 32, 34. The clamping trigger 12 is squeezed to cause
the sheath 38 to move over the camming surface 27 and thereby close the jaws 32, 34
and simultaneously close the electrical circuit as described above. The electrode bars
53, 54 and the insulating material 55, which together form the ridge 56, compress the
tissue against the inner surface 35 of jaw member 34. A user then applies RF energy
from the generator 60 using the footswitch 65 or other switch. Current flows through
the compressed tissue between the first pole 52, i.e. the bars 53, 54, and the second
pole 51, i.e., the anvil 18.
In one embodiment of the present invention the initial pressure applied to
compress the tissue in the compression zone is between approximately 30 pounds per
square inch (psi) and 250 psi. More particularly, in a further embodiment of the
present invention the initial pressure applied to compress the tissue in the compression
zone is between approximately 75 psi and 250 psi. More particularly in a further
embodiment of the present invention the initial pressure applied to compress the tissue
in the compression zone is between approximately 75 psi and 175 psi. In one
embodiment of the present invention, the initial pressure applied to compress tissue
positioned between the jaws is approximately 125 psi. With sufficient pressure applied
fluid, including blood, is forced out of the tissue in the compression zone, facilitating
coagulation. In addition, pressure applied to tissue within the compression zone
facilitates coupling of electrosurgical energy to the tissue by forcing the tissue against
the electrode.
The pressure exerted by the anvil is a function of the spring rate of the anvil.
By providing a "pre-bend" angle on the anvil it is possible to obtain a pre-load (at a
zero gap.) Thus, where a pre-bend angle is applied, the anvil may be viewed as a
prestressed beam. A Preferred value of preload is in the range of between 12 and 18
pounds with a preferred value of approximately 15 pounds. The spring rate of the
anvil is more accurately a function of the stiffness of the "system", where the system
includes the anvil, channel, cartridge, tube, etc. Each of the elements of the system
has a particular spring rate and each may be suitably modified to increase the stiffness
of the system.
In one embodiment of the present invention, that the spring rate of jaw 32 is
between approximately 225 pounds per inch and approximately 350 pounds per inch.
More particularly, the spring rate of anvil 18 on jaw 32 is preferably in the range of
approximately 275 pounds per inch.
Preferably the bipolar energy source is a low impedance source providing
radio frequency energy from about 300 kHz to 3 MHZ. Preferably, the current
delivered to the tissue is from 0.1 to 1.5 amps and the voltage is from 30 to 200 volts
RMS.
An audible, visible, tactile, or other feedback system may be used to indicate
when sufficient cauterization has occurred at which point the RF energy may be turned
off. An example of such a feedback system is described below. After the RF energy
is turned off, the cutting means 11 is advanced and the staples 100 are fired using the
firing trigger 14. Firing is accomplished by rotating the firing trigger 14 acting as a
lever arm about pivot 14a. The driver means 44 advances the cutting means 11 and
wedge 13. The cutting means 11 cuts the tissue in between the bars 53, 54 where the
tissue has been cauterized. Thus, the cut line is lateral to the coagulation lines formed
by the bar electrodes. The wedge 13 simultaneously advances the drivers 24 into the
staples 100 causing the staples 100 to fire through tissue and into the pockets 36, 37 of
the anvil 18. Staples 100 are applied in two longitudinal double rows on each side of
the cutting means 11 as the cutting means cuts the tissue.
Operation of linear staplers are known in the art and are discussed, for
example, in U.S. patent Nos. 4,608,981, 4,633,874, and U.S. Application Serial No.
07/917,636 incorporated herein by reference.
In one embodiment the cartridge provides multifire stapling capabilities by
replacing the double row of staples with a single row. In the laparoscopic stapling and
cutting devices presently in use, a single shot replaceable cartridge is used. In order to
provide better hemostasis, this type of stapler was designed to provide a double row of
staples for each parallel row. Because of the size of the space necessary to contain the
double row of staples, a refireable cartridge with stacked staples has not been
preferred because of the additional space required for stacking staples. In the multifire
stapling embodiment a single row of staples is used. Using a single row of staples
permits stacking of staples in the space previously occupied by the second row of
staples, providing multifire capabilities. In a further embodiment, no staples are
required and the electrical current lines provide the necessary hemostasis.
A preferred embodiment of the present invention includes a feedback system
designed to indicate when a desired or predetermined degree of coagulation has
occurred. This is particularly useful where the coagulation zone is not visible to the
user. In a particular embodiment, the feedback system measures electrical parameters
of the system which include coagulation level.
The feedback system may also determine tissue characteristics at or near a
coagulation zone which indicate degree of coagulation. The electrical impedance of
the tissue to which the electrical energy is applied may also be used to indicate
coagulation. Generally, as energy is applied to the tissue, the impedance will initially
decrease and then rise as coagulation occurs. An example of the relationship between
electrical tissue impedance over time and coagulation is described in Vaellfors, Bertil
and Bergdahl, Bjoern "Automatically controlled Bipolar Electrocoagulation,"
Neurosurg. Rev. p. 187-190 (1984) incorporated herein by reference. Also as
desiccation occurs, impedance increases. tissue carbonization and or sticking to
instrument as a result of over application of high voltage may be prevented using a
feedback system based on tissue impedance characteristics. Other examples of tissue
characteristics which may indicate coagulation include temperature and light
reflectance.
Referring to Figure 10, a flow chart illustrates a feedback system which is
implemented in a preferred embodiment of the present invention. First, energy is
applied to the tissue. Then the system current and voltage applied to the tissue is
determined. The impedance value is calculated and stored. Based on a function of the
impedance, for example, which may include the impedance, the change in impedance,
and/or the rate of change in impedance, it is determined whether desired coagulation
has occurred. If coagulation has occurred to a predetermined or desired degree, an
indication means indicates that the energy should be turned off. Such an indication
means may include a visible light, an audible sound or a tactile indicator. The
feedback means may also control the generator and turn the energy off at a certain
impedance level. An alternative embodiment provides a continuous audible sound in
which the tone varies depending on the impedance level. An additional feature
provides an error indication means for indicating an error or instrument malfunction
when the impedance is below a normal minimum and/ or above a maximum range.
Figures 11-14 illustrate alternative configurations of an end effector. In Figure
11 the first pole 152 and the second pole 151 are both located on the same jaw 132
having the anvil 118. The U-shaped first pole 152 forms the knife channel 142. A U-shaped
insulator 155 surrounds the first pole 152 except on the surface 133 so that it is
electrically isolated from the second pole 151. The compression ridge 156 is formed
on the cartridge which is made from an electrically non-conductive material. The
ridge 156 compresses tissue against the first pole 152 and insulator 155 to form a
tissue compression zone.
In Figure 12, the first pole 252 and the second pole 251 are both located on the
same jaw 232 having the anvil 218. The first pole 252 and the second pole 251 each
are located on opposing sides of the knife channel 242. An insulator 255 surrounds
the poles 251, 252 except on the surface 233 so that the poles 251, 252 are electrically
isolated from each other. The compression ridge 256 is formed on the cartridge which
is made from an electrically non-conductive material. The ridge 256 compresses
tissue against the poles 251, 252 and insulator 255 to form a tissue compression zone.
In Figure 13, second pole 351 is located on the jaw 332 having the anvil 318
while the first pole 352 is located on the cartridge 323. The U-shaped first pole 352
forms the knife channel 326 and is surrounded by insulator 355a. A U-shaped
insulator 355b forms the knife channel 342 in jaw 332. Except for the insulator 355b,
the jaw is formed of an electrically conductive material which makes up the second
pole 351. The first pole 352 and the insulator 355a form the compression ridge 356
which compresses tissue against the surface 333 of jaw 332 to form a compression
zone. The insulator 355b is of sufficient width that it prevents poles 351, 352 form
contacting when the jaws 332,334 are closed.
In Figure 14, the first pole 452 and the second pole 451 are both located on the
jaw 434 having the cartridge 423. The first pole 452 and the second pole 451 each are
located on opposing sides, forming the knife channel 426 through the cartridge 423.
An insulator 455a surrounds the poles 451, 452 except on the surface 435, so that the
poles 451, 452 are electrically isolated from each other. The compression ridge 456
is formed on the cartridge 423 and forms a compression zone by compressing tissue
against an insulator 455b disposed on the surface 433 of the jaw 432.
Figure 15 illustrates an alternative embodiment. The first and second poles
551, 552 and knife channel 542 are arranged in a similar configuration as in Figure 12
except that the first and second poles 551 and 552 each comprise a series of electrically
connected electrodes staggered along the length of the knife channel with insulating
material in between staggered electrodes.
Figure 16 illustrates staggered electrodes as in Fig 15 but with first pole
electrodes 652 and second pole electrodes 651 alternating along the length of the knife
channel 642 and on each side of the knife channel 642.
Figs. 17 and 18 illustrate another embodiment in which first and second poles
751, 752 each comprise staggered electrodes. In this embodiment, the first pole 752 is
staggered along each side of the knife channel 126 and located on the compression
ridge 756 formed on the cartridge 723. The second pole 751 is staggered along each
side of the knife channel 742 on the surface 733 of jaw 732. As can be seen from
Figure 18, the poles 751, 752 are vertically aligned, but as illustrated in Figure 17, are
staggered so that when the jaws 732, 734 are closed, the poles are electrically isolated
from each other by insulators 755a, 755b.
Figure 19 illustrates an alternative embodiment of the end effector. The first
pole 852 and the second pole 851 are both located on the jaw 832 having an anvil 818.
The first pole 852 forms the ridge 856 for compressing tissue in a compression zone
and is located on interfacing surface 833. The second pole 851 is located on the side
of the anvil 818 and not on interfacing surface 833.
Figs. 20 and 21 illustrate a circular cutter of the present invention with stapling
means. Figure 20 illustrates the stapler cartridge 900 with an interfacing surface 933.
A double row of staple apertures 901 through which staples are driven into tissue are
staggered about the outer circumference of the surface 932. A first pole 952 encircles
the inner circumference of the surface 933. An insulator 955 electrically isolates the
first pole 952 from the portion 933a of the surface 933 surrounding the staple
apertures. The staple aperture portion 933a is formed of an electrically conductive
material and acts as a second pole. A circular cutting knife 911 is recessed within the
cartridge 900 radially inward from the inner circumference of the surface 933.
Figure 21 illustrates an anvil 918 with pockets 937 for receiving staples and a
compression ridge 956 for compressing tissue against the first pole 952 and insulator
955 of the cartridge. The circular cutter is operated similarly to the circular stapler
described in U.S. Patent No. 5,104,025 incorporated herein by reference. Prior to
stapling and cutting however, tissue welding electrical current may be delivered
between the first pole 952 and the staple aperture portion 933a to tissue.
In an alternative embodiment, the circular cutter may be used without staples.
Electrical current is delivered through the poles to weld and coagulate tissue, then the
knife may be advanced to cut tissue in a procedure such as an anastomosis.
In operation, the jaws of the instrument, for example, jaws 32 and 34 of end
effector 50, are closed around the tissue which is to be treated. Tissue trapped
between the instrument jaws is compressed as described herein
An electrosurgical instrument according to the present invention is beneficial in
that coagulation of tissue is enhanced since the pressures applied force fluid out of the
coagulation region without tearing the tissue. The pressure ranges specified herein are
also beneficial in that, using an instrument according to the present invention, contact
between the tissue and electrodes is improved, coagulation is improved throughout the
tissue and charring is reduced.
Several variations of this invention has been described in connection with two
specific embodiments involving endoscopic cutting and stapling. Naturally, the
invention may be used in numerous applications where hemostasis in desired.
Accordingly, will be understood by those skilled in the art that various changes and
modifications may be made in the invention without departing from its scope, which is
defined by the following claims and their equivalents.
Claims (10)
- An electrosurgical device having an end effector, wherein said end effector comprises:first and second opposing interfacing surfaces said interfacing surfaces capable of engaging tissue therebetween, and said end effector capable of receiving bipolar energy therein, said first and second interfacing surfaces applying a predetermined pressure to said tissue in a range of between approximately thirty pounds per square inch and approximately two hundred fifty pounds per square inch;electrically isolated first and second poles comprising electrically opposite electrodes capable of conducting bipolar energy therethrough; wherein said first pole is comprised of one or more first electrodes of a first electrical potential; wherein said second pole is comprised of one or more second electrodes of a second electrical potential;wherein at least one of said one or more first electrodes is located on at least one of said first and said second interfacing surfaces and wherein at least one of said one or more second electrodes is located on at least one of said first and second interfacing surfaces, so that bipolar energy may be communicated between said poles through the tissue; andwherein each said one or more first electrodes is offset from each said one or more second electrodes, at said first and second interfacing surfaces.
- An electrosurgical device comprising:a handle;an actuating means coupled to said handle,an end effector coupled to the distal end of said actuating means;a means for communicating bipolar electrical energy from a bipolar energy source to said end effector;said end effector including:a first interfacing surface;a second interfacing surface;a first pole comprising one or more first electrodes of a first electrical potential located on at least one of said interfacing surfaces;a second pole comprising one or more second electrodes of a second electrical potential located on at least one of said interfacing surfaces, andan insulator arranged to offset each of said one or more first electrodes from each of said one or more second electrodes, at said interfacing surfaces;wherein said actuating means is capable of causing said end effector to engage tissue between the first interfacing surface and the second interfacing surface, and applying a predetermined pressure to said tissue in a range of between approximately thirty pounds per square inch and approximately two hundred fifty pounds per square inch;wherein said first pole and said second pole are comprised of electrically opposite electrodes capable of conducting electrical energy supplied from said means for communicating bipolar electrical energy from a bipolar energy source, through tissue adjacent to said one or more first electrodes and said one or more second electrodes.
- The electrosurgical device of claim 1 or claim 2 wherein said predetermined pressure is in a range of between approximately seventy five pounds per square inch and approximately two hundred fifty pounds per square inch.
- The electrosurgical device of claim 1 or claim 2 wherein said predetermined pressure is in a range of between approximately one hundred fifteen pounds per square inch and one hundred eighty five pounds per square inch.
- The electrosurgical device of any preceding claim wherein a portion of said second interfacing surface comprises a ridge extending from said second interfacing surface to form a tissue compression zone between interfacing surfaces.
- The electrosurgical device of claim 5 wherein current flowing between said first and second poles provides coagulation in the compression zone.
- The electrosurgical device of any preceding claim wherein said device includes a cutting element adapted to divide tissue engaged by said interfacing surfaces.
- The electrosurgical device of claim 7 wherein said cutting element is arranged to divide tissue engaged by said end effector through a cutting line when said cutting element is actuated.
- The electrosurgical device of claim 8 wherein said end effector further comprises at least one staple and at least one driver adapted to apply said at least one staple lateral to said cutting line.
- The electrosurgical device of any preceding claim wherein said one or more first electrodes comprises an electrode having a relatively circular shape and is located on an outer circumference of said first interfacing surface.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US08/856,520 USH1904H (en) | 1997-05-14 | 1997-05-14 | Electrosurgical hemostatic method and device |
US856520 | 1997-05-14 |
Publications (1)
Publication Number | Publication Date |
---|---|
EP0878168A1 true EP0878168A1 (en) | 1998-11-18 |
Family
ID=25323832
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP98303753A Withdrawn EP0878168A1 (en) | 1997-05-14 | 1998-05-13 | Electrosurgical hemostatic device |
Country Status (5)
Country | Link |
---|---|
US (1) | USH1904H (en) |
EP (1) | EP0878168A1 (en) |
JP (1) | JPH1170123A (en) |
AU (1) | AU6487098A (en) |
CA (1) | CA2237429A1 (en) |
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US8460331B2 (en) | 1998-08-12 | 2013-06-11 | Maquet Cardiovascular, Llc | Tissue dissector apparatus and method |
US8915910B2 (en) | 2008-03-31 | 2014-12-23 | Applied Medical Resources Corporation | Electrosurgical system |
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US10420603B2 (en) | 2014-12-23 | 2019-09-24 | Applied Medical Resources Corporation | Bipolar electrosurgical sealer and divider |
US10507012B2 (en) | 2000-11-17 | 2019-12-17 | Maquet Cardiovascular Llc | Vein harvesting system and method |
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US11864812B2 (en) | 2018-09-05 | 2024-01-09 | Applied Medical Resources Corporation | Electrosurgical generator control system |
Families Citing this family (1073)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6096037A (en) | 1997-07-29 | 2000-08-01 | Medtronic, Inc. | Tissue sealing electrosurgery device and methods of sealing tissue |
US6726686B2 (en) | 1997-11-12 | 2004-04-27 | Sherwood Services Ag | Bipolar electrosurgical instrument for sealing vessels |
US6352536B1 (en) | 2000-02-11 | 2002-03-05 | Sherwood Services Ag | Bipolar electrosurgical instrument for sealing vessels |
US7435249B2 (en) | 1997-11-12 | 2008-10-14 | Covidien Ag | Electrosurgical instruments which reduces collateral damage to adjacent tissue |
US20030014052A1 (en) * | 1997-11-14 | 2003-01-16 | Buysse Steven P. | Laparoscopic bipolar electrosurgical instrument |
US6228083B1 (en) | 1997-11-14 | 2001-05-08 | Sherwood Services Ag | Laparoscopic bipolar electrosurgical instrument |
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US7364577B2 (en) | 2002-02-11 | 2008-04-29 | Sherwood Services Ag | Vessel sealing system |
US7118570B2 (en) | 2001-04-06 | 2006-10-10 | Sherwood Services Ag | Vessel sealing forceps with disposable electrodes |
US7582087B2 (en) | 1998-10-23 | 2009-09-01 | Covidien Ag | Vessel sealing instrument |
US7267677B2 (en) | 1998-10-23 | 2007-09-11 | Sherwood Services Ag | Vessel sealing instrument |
US7887535B2 (en) | 1999-10-18 | 2011-02-15 | Covidien Ag | Vessel sealing wave jaw |
US20030109875A1 (en) | 1999-10-22 | 2003-06-12 | Tetzlaff Philip M. | Open vessel sealing forceps with disposable electrodes |
US6689131B2 (en) | 2001-03-08 | 2004-02-10 | Tissuelink Medical, Inc. | Electrosurgical device having a tissue reduction sensor |
US6953461B2 (en) * | 2002-05-16 | 2005-10-11 | Tissuelink Medical, Inc. | Fluid-assisted medical devices, systems and methods |
US7811282B2 (en) | 2000-03-06 | 2010-10-12 | Salient Surgical Technologies, Inc. | Fluid-assisted electrosurgical devices, electrosurgical unit with pump and methods of use thereof |
US6702810B2 (en) | 2000-03-06 | 2004-03-09 | Tissuelink Medical Inc. | Fluid delivery system and controller for electrosurgical devices |
US8048070B2 (en) | 2000-03-06 | 2011-11-01 | Salient Surgical Technologies, Inc. | Fluid-assisted medical devices, systems and methods |
US6558385B1 (en) | 2000-09-22 | 2003-05-06 | Tissuelink Medical, Inc. | Fluid-assisted medical device |
EP1372506B1 (en) | 2001-04-06 | 2006-06-28 | Sherwood Services AG | Electrosurgical instrument which reduces collateral damage to adjacent tissue |
DE60121229T2 (en) | 2001-04-06 | 2007-05-24 | Sherwood Services Ag | DEVICE FOR SEALING AND SHARING A VESSEL WITH NON-LASTING END STOP |
US10849681B2 (en) | 2001-04-06 | 2020-12-01 | Covidien Ag | Vessel sealer and divider |
US7101372B2 (en) * | 2001-04-06 | 2006-09-05 | Sherwood Sevices Ag | Vessel sealer and divider |
US7101371B2 (en) | 2001-04-06 | 2006-09-05 | Dycus Sean T | Vessel sealer and divider |
ES2250379T3 (en) * | 2001-04-06 | 2006-04-16 | Sherwood Serv Ag | GLASS SUTURE INSTRUMENT. |
US10835307B2 (en) | 2001-06-12 | 2020-11-17 | Ethicon Llc | Modular battery powered handheld surgical instrument containing elongated multi-layered shaft |
US10285694B2 (en) | 2001-10-20 | 2019-05-14 | Covidien Lp | Surgical stapler with timer and feedback display |
US7464847B2 (en) | 2005-06-03 | 2008-12-16 | Tyco Healthcare Group Lp | Surgical stapler with timer and feedback display |
US7041102B2 (en) * | 2001-10-22 | 2006-05-09 | Surgrx, Inc. | Electrosurgical working end with replaceable cartridges |
US8075558B2 (en) | 2002-04-30 | 2011-12-13 | Surgrx, Inc. | Electrosurgical instrument and method |
WO2003068046A2 (en) | 2002-02-13 | 2003-08-21 | Applied Medical Resources Corporation | Tissue fusion/welder apparatus corporation |
EP2404555B1 (en) * | 2002-04-16 | 2017-03-15 | Covidien LP | Surgical stapler and method |
WO2003094746A1 (en) | 2002-05-10 | 2003-11-20 | Tyco Healthcare Group, Lp | Surgical stapling apparatus having a wound closure material applicator assembly |
JP4046569B2 (en) * | 2002-07-30 | 2008-02-13 | オリンパス株式会社 | Surgical instrument |
US7276068B2 (en) | 2002-10-04 | 2007-10-02 | Sherwood Services Ag | Vessel sealing instrument with electrical cutting mechanism |
US7931649B2 (en) | 2002-10-04 | 2011-04-26 | Tyco Healthcare Group Lp | Vessel sealing instrument with electrical cutting mechanism |
US7270664B2 (en) | 2002-10-04 | 2007-09-18 | Sherwood Services Ag | Vessel sealing instrument with electrical cutting mechanism |
WO2004039416A2 (en) | 2002-10-29 | 2004-05-13 | Tissuelink Medical, Inc. | Fluid-assisted electrosurgical scissors and methods |
US7799026B2 (en) | 2002-11-14 | 2010-09-21 | Covidien Ag | Compressible jaw configuration with bipolar RF output electrodes for soft tissue fusion |
US7776036B2 (en) | 2003-03-13 | 2010-08-17 | Covidien Ag | Bipolar concentric electrode assembly for soft tissue fusion |
US8128624B2 (en) | 2003-05-01 | 2012-03-06 | Covidien Ag | Electrosurgical instrument that directs energy delivery and protects adjacent tissue |
US7160299B2 (en) | 2003-05-01 | 2007-01-09 | Sherwood Services Ag | Method of fusing biomaterials with radiofrequency energy |
CA2523675C (en) | 2003-05-01 | 2016-04-26 | Sherwood Services Ag | Electrosurgical instrument which reduces thermal damage to adjacent tissue |
ES2368488T3 (en) | 2003-05-15 | 2011-11-17 | Covidien Ag | FABRIC SEALER WITH VARIABLE BUMPER MEMBERS SELECTIVELY AND NON-DRIVING. |
US9060770B2 (en) | 2003-05-20 | 2015-06-23 | Ethicon Endo-Surgery, Inc. | Robotically-driven surgical instrument with E-beam driver |
US20070084897A1 (en) | 2003-05-20 | 2007-04-19 | Shelton Frederick E Iv | Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism |
US7156846B2 (en) | 2003-06-13 | 2007-01-02 | Sherwood Services Ag | Vessel sealer and divider for use with small trocars and cannulas |
US7150749B2 (en) | 2003-06-13 | 2006-12-19 | Sherwood Services Ag | Vessel sealer and divider having elongated knife stroke and safety cutting mechanism |
USD956973S1 (en) | 2003-06-13 | 2022-07-05 | Covidien Ag | Movable handle for endoscopic vessel sealer and divider |
US7857812B2 (en) | 2003-06-13 | 2010-12-28 | Covidien Ag | Vessel sealer and divider having elongated knife stroke and safety for cutting mechanism |
US9848938B2 (en) | 2003-11-13 | 2017-12-26 | Covidien Ag | Compressible jaw configuration with bipolar RF output electrodes for soft tissue fusion |
US7367976B2 (en) | 2003-11-17 | 2008-05-06 | Sherwood Services Ag | Bipolar forceps having monopolar extension |
US7131970B2 (en) | 2003-11-19 | 2006-11-07 | Sherwood Services Ag | Open vessel sealing instrument with cutting mechanism |
US7500975B2 (en) | 2003-11-19 | 2009-03-10 | Covidien Ag | Spring loaded reciprocating tissue cutting mechanism in a forceps-style electrosurgical instrument |
US7811283B2 (en) | 2003-11-19 | 2010-10-12 | Covidien Ag | Open vessel sealing instrument with hourglass cutting mechanism and over-ratchet safety |
US7442193B2 (en) | 2003-11-20 | 2008-10-28 | Covidien Ag | Electrically conductive/insulative over-shoe for tissue fusion |
US7632269B2 (en) | 2004-01-16 | 2009-12-15 | Ethicon Endo-Surgery, Inc. | Electrosurgical instrument with replaceable cartridge |
US7727232B1 (en) | 2004-02-04 | 2010-06-01 | Salient Surgical Technologies, Inc. | Fluid-assisted medical devices and methods |
US8182501B2 (en) | 2004-02-27 | 2012-05-22 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical shears and method for sealing a blood vessel using same |
US7780662B2 (en) | 2004-03-02 | 2010-08-24 | Covidien Ag | Vessel sealing system using capacitive RF dielectric heating |
US7955331B2 (en) | 2004-03-12 | 2011-06-07 | Ethicon Endo-Surgery, Inc. | Electrosurgical instrument and method of use |
US8215531B2 (en) | 2004-07-28 | 2012-07-10 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a medical substance dispenser |
US11896225B2 (en) | 2004-07-28 | 2024-02-13 | Cilag Gmbh International | Staple cartridge comprising a pan |
DE102004040959B4 (en) * | 2004-08-24 | 2008-12-24 | Erbe Elektromedizin Gmbh | Surgical instrument |
US7195631B2 (en) | 2004-09-09 | 2007-03-27 | Sherwood Services Ag | Forceps with spring loaded end effector assembly |
US7540872B2 (en) | 2004-09-21 | 2009-06-02 | Covidien Ag | Articulating bipolar electrosurgical instrument |
US7955332B2 (en) | 2004-10-08 | 2011-06-07 | Covidien Ag | Mechanism for dividing tissue in a hemostat-style instrument |
AU2005295010B2 (en) | 2004-10-08 | 2012-05-31 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instrument |
US7455682B2 (en) | 2004-10-18 | 2008-11-25 | Tyco Healthcare Group Lp | Structure containing wound treatment material |
US7686827B2 (en) | 2004-10-21 | 2010-03-30 | Covidien Ag | Magnetic closure mechanism for hemostat |
US7686804B2 (en) | 2005-01-14 | 2010-03-30 | Covidien Ag | Vessel sealer and divider with rotating sealer and cutter |
US7909823B2 (en) | 2005-01-14 | 2011-03-22 | Covidien Ag | Open vessel sealing instrument |
US7491202B2 (en) | 2005-03-31 | 2009-02-17 | Covidien Ag | Electrosurgical forceps with slow closure sealing plates and method of sealing tissue |
US8728072B2 (en) | 2005-05-12 | 2014-05-20 | Aesculap Ag | Electrocautery method and apparatus |
US9339323B2 (en) | 2005-05-12 | 2016-05-17 | Aesculap Ag | Electrocautery method and apparatus |
US7942874B2 (en) | 2005-05-12 | 2011-05-17 | Aragon Surgical, Inc. | Apparatus for tissue cauterization |
US8696662B2 (en) | 2005-05-12 | 2014-04-15 | Aesculap Ag | Electrocautery method and apparatus |
US11291443B2 (en) | 2005-06-03 | 2022-04-05 | Covidien Lp | Surgical stapler with timer and feedback display |
EP1937157B1 (en) | 2005-06-03 | 2020-08-05 | Covidien LP | Surgical stapler with timer and feedback display |
US7717312B2 (en) * | 2005-06-03 | 2010-05-18 | Tyco Healthcare Group Lp | Surgical instruments employing sensors |
US7837685B2 (en) | 2005-07-13 | 2010-11-23 | Covidien Ag | Switch mechanisms for safe activation of energy on an electrosurgical instrument |
US7628791B2 (en) | 2005-08-19 | 2009-12-08 | Covidien Ag | Single action tissue sealer |
US8800838B2 (en) | 2005-08-31 | 2014-08-12 | Ethicon Endo-Surgery, Inc. | Robotically-controlled cable-based surgical end effectors |
US20070194082A1 (en) | 2005-08-31 | 2007-08-23 | Morgan Jerome R | Surgical stapling device with anvil having staple forming pockets of varying depths |
US9237891B2 (en) | 2005-08-31 | 2016-01-19 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical stapling devices that produce formed staples having different lengths |
US7934630B2 (en) | 2005-08-31 | 2011-05-03 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
US7669746B2 (en) | 2005-08-31 | 2010-03-02 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
US11246590B2 (en) | 2005-08-31 | 2022-02-15 | Cilag Gmbh International | Staple cartridge including staple drivers having different unfired heights |
US11484312B2 (en) | 2005-08-31 | 2022-11-01 | Cilag Gmbh International | Staple cartridge comprising a staple driver arrangement |
US10159482B2 (en) | 2005-08-31 | 2018-12-25 | Ethicon Llc | Fastener cartridge assembly comprising a fixed anvil and different staple heights |
US7879035B2 (en) | 2005-09-30 | 2011-02-01 | Covidien Ag | Insulating boot for electrosurgical forceps |
US7722607B2 (en) | 2005-09-30 | 2010-05-25 | Covidien Ag | In-line vessel sealer and divider |
AU2006225175B2 (en) | 2005-09-30 | 2012-08-30 | Covidien Ag | Insulating boot for electrosurgical forceps |
US7922953B2 (en) | 2005-09-30 | 2011-04-12 | Covidien Ag | Method for manufacturing an end effector assembly |
CA2561034C (en) | 2005-09-30 | 2014-12-09 | Sherwood Services Ag | Flexible endoscopic catheter with an end effector for coagulating and transfecting tissue |
US7789878B2 (en) | 2005-09-30 | 2010-09-07 | Covidien Ag | In-line vessel sealer and divider |
US20070191713A1 (en) | 2005-10-14 | 2007-08-16 | Eichmann Stephen E | Ultrasonic device for cutting and coagulating |
US7673783B2 (en) | 2005-11-04 | 2010-03-09 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments structured for delivery of medical agents |
US7799039B2 (en) | 2005-11-09 | 2010-09-21 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a hydraulically actuated end effector |
US7673780B2 (en) | 2005-11-09 | 2010-03-09 | Ethicon Endo-Surgery, Inc. | Articulation joint with improved moment arm extension for articulating an end effector of a surgical instrument |
US20070106317A1 (en) | 2005-11-09 | 2007-05-10 | Shelton Frederick E Iv | Hydraulically and electrically actuated articulation joints for surgical instruments |
US7670334B2 (en) | 2006-01-10 | 2010-03-02 | Ethicon Endo-Surgery, Inc. | Surgical instrument having an articulating end effector |
US7621930B2 (en) | 2006-01-20 | 2009-11-24 | Ethicon Endo-Surgery, Inc. | Ultrasound medical instrument having a medical ultrasonic blade |
US8241282B2 (en) | 2006-01-24 | 2012-08-14 | Tyco Healthcare Group Lp | Vessel sealing cutting assemblies |
US8734443B2 (en) | 2006-01-24 | 2014-05-27 | Covidien Lp | Vessel sealer and divider for large tissue structures |
US8882766B2 (en) | 2006-01-24 | 2014-11-11 | Covidien Ag | Method and system for controlling delivery of energy to divide tissue |
US7766910B2 (en) | 2006-01-24 | 2010-08-03 | Tyco Healthcare Group Lp | Vessel sealer and divider for large tissue structures |
US8298232B2 (en) | 2006-01-24 | 2012-10-30 | Tyco Healthcare Group Lp | Endoscopic vessel sealer and divider for large tissue structures |
US8820603B2 (en) | 2006-01-31 | 2014-09-02 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of a surgical instrument |
US11278279B2 (en) | 2006-01-31 | 2022-03-22 | Cilag Gmbh International | Surgical instrument assembly |
US8708213B2 (en) | 2006-01-31 | 2014-04-29 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a feedback system |
US20110024477A1 (en) | 2009-02-06 | 2011-02-03 | Hall Steven G | Driven Surgical Stapler Improvements |
US8763879B2 (en) | 2006-01-31 | 2014-07-01 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of surgical instrument |
US7644848B2 (en) | 2006-01-31 | 2010-01-12 | Ethicon Endo-Surgery, Inc. | Electronic lockouts and surgical instrument including same |
US8186555B2 (en) | 2006-01-31 | 2012-05-29 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting and fastening instrument with mechanical closure system |
US7845537B2 (en) | 2006-01-31 | 2010-12-07 | Ethicon Endo-Surgery, Inc. | Surgical instrument having recording capabilities |
US20110290856A1 (en) | 2006-01-31 | 2011-12-01 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical instrument with force-feedback capabilities |
US20110006101A1 (en) | 2009-02-06 | 2011-01-13 | EthiconEndo-Surgery, Inc. | Motor driven surgical fastener device with cutting member lockout arrangements |
US11224427B2 (en) | 2006-01-31 | 2022-01-18 | Cilag Gmbh International | Surgical stapling system including a console and retraction assembly |
US11793518B2 (en) | 2006-01-31 | 2023-10-24 | Cilag Gmbh International | Powered surgical instruments with firing system lockout arrangements |
US20120292367A1 (en) | 2006-01-31 | 2012-11-22 | Ethicon Endo-Surgery, Inc. | Robotically-controlled end effector |
US7568603B2 (en) | 2006-01-31 | 2009-08-04 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting and fastening instrument with articulatable end effector |
US7766210B2 (en) | 2006-01-31 | 2010-08-03 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting and fastening instrument with user feedback system |
US8161977B2 (en) | 2006-01-31 | 2012-04-24 | Ethicon Endo-Surgery, Inc. | Accessing data stored in a memory of a surgical instrument |
US9861359B2 (en) | 2006-01-31 | 2018-01-09 | Ethicon Llc | Powered surgical instruments with firing system lockout arrangements |
US7770775B2 (en) | 2006-01-31 | 2010-08-10 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting and fastening instrument with adaptive user feedback |
US7753904B2 (en) | 2006-01-31 | 2010-07-13 | Ethicon Endo-Surgery, Inc. | Endoscopic surgical instrument with a handle that can articulate with respect to the shaft |
US8062236B2 (en) | 2006-02-02 | 2011-11-22 | Tyco Healthcare Group, Lp | Method and system to determine an optimal tissue compression time to implant a surgical element |
US7645278B2 (en) * | 2006-02-22 | 2010-01-12 | Olympus Corporation | Coagulating cutter |
US20070225562A1 (en) | 2006-03-23 | 2007-09-27 | Ethicon Endo-Surgery, Inc. | Articulating endoscopic accessory channel |
US8992422B2 (en) | 2006-03-23 | 2015-03-31 | Ethicon Endo-Surgery, Inc. | Robotically-controlled endoscopic accessory channel |
US7846158B2 (en) | 2006-05-05 | 2010-12-07 | Covidien Ag | Apparatus and method for electrode thermosurgery |
US8322455B2 (en) | 2006-06-27 | 2012-12-04 | Ethicon Endo-Surgery, Inc. | Manually driven surgical cutting and fastening instrument |
US7776037B2 (en) | 2006-07-07 | 2010-08-17 | Covidien Ag | System and method for controlling electrode gap during tissue sealing |
US7744615B2 (en) | 2006-07-18 | 2010-06-29 | Covidien Ag | Apparatus and method for transecting tissue on a bipolar vessel sealing instrument |
US7740159B2 (en) | 2006-08-02 | 2010-06-22 | Ethicon Endo-Surgery, Inc. | Pneumatically powered surgical cutting and fastening instrument with a variable control of the actuating rate of firing with mechanical power assist |
US8597297B2 (en) | 2006-08-29 | 2013-12-03 | Covidien Ag | Vessel sealing instrument with multiple electrode configurations |
US10130359B2 (en) | 2006-09-29 | 2018-11-20 | Ethicon Llc | Method for forming a staple |
US8485412B2 (en) | 2006-09-29 | 2013-07-16 | Ethicon Endo-Surgery, Inc. | Surgical staples having attached drivers and stapling instruments for deploying the same |
US10568652B2 (en) | 2006-09-29 | 2020-02-25 | Ethicon Llc | Surgical staples having attached drivers of different heights and stapling instruments for deploying the same |
US8070746B2 (en) | 2006-10-03 | 2011-12-06 | Tyco Healthcare Group Lp | Radiofrequency fusion of cardiac tissue |
US7963431B2 (en) * | 2006-10-06 | 2011-06-21 | Tyco Healthcare Group, Lp | Grasping jaw mechanism |
US8475453B2 (en) | 2006-10-06 | 2013-07-02 | Covidien Lp | Endoscopic vessel sealer and divider having a flexible articulating shaft |
US7967178B2 (en) | 2006-10-06 | 2011-06-28 | Tyco Healthcare Group Lp | Grasping jaw mechanism |
US8336751B2 (en) | 2006-10-06 | 2012-12-25 | Covidien Lp | Grasping jaw mechanism |
US7951149B2 (en) | 2006-10-17 | 2011-05-31 | Tyco Healthcare Group Lp | Ablative material for use with tissue treatment device |
US8459520B2 (en) | 2007-01-10 | 2013-06-11 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between control unit and remote sensor |
US8684253B2 (en) | 2007-01-10 | 2014-04-01 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor |
US11291441B2 (en) | 2007-01-10 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with wireless communication between control unit and remote sensor |
US8652120B2 (en) | 2007-01-10 | 2014-02-18 | Ethicon Endo-Surgery, Inc. | Surgical instrument with wireless communication between control unit and sensor transponders |
US8701958B2 (en) | 2007-01-11 | 2014-04-22 | Ethicon Endo-Surgery, Inc. | Curved end effector for a surgical stapling device |
US11039836B2 (en) | 2007-01-11 | 2021-06-22 | Cilag Gmbh International | Staple cartridge for use with a surgical stapling instrument |
USD649249S1 (en) | 2007-02-15 | 2011-11-22 | Tyco Healthcare Group Lp | End effectors of an elongated dissecting and dividing instrument |
US8727197B2 (en) | 2007-03-15 | 2014-05-20 | Ethicon Endo-Surgery, Inc. | Staple cartridge cavity configuration with cooperative surgical staple |
US7431188B1 (en) | 2007-03-15 | 2008-10-07 | Tyco Healthcare Group Lp | Surgical stapling apparatus with powered articulation |
US8057498B2 (en) | 2007-11-30 | 2011-11-15 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instrument blades |
US8142461B2 (en) | 2007-03-22 | 2012-03-27 | Ethicon Endo-Surgery, Inc. | Surgical instruments |
US8911460B2 (en) | 2007-03-22 | 2014-12-16 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
US8893946B2 (en) | 2007-03-28 | 2014-11-25 | Ethicon Endo-Surgery, Inc. | Laparoscopic tissue thickness and clamp load measuring devices |
US8267935B2 (en) | 2007-04-04 | 2012-09-18 | Tyco Healthcare Group Lp | Electrosurgical instrument reducing current densities at an insulator conductor junction |
US11259802B2 (en) | 2007-04-13 | 2022-03-01 | Covidien Lp | Powered surgical instrument |
US20080255413A1 (en) | 2007-04-13 | 2008-10-16 | Michael Zemlok | Powered surgical instrument |
US8800837B2 (en) | 2007-04-13 | 2014-08-12 | Covidien Lp | Powered surgical instrument |
US7950560B2 (en) | 2007-04-13 | 2011-05-31 | Tyco Healthcare Group Lp | Powered surgical instrument |
US7823760B2 (en) | 2007-05-01 | 2010-11-02 | Tyco Healthcare Group Lp | Powered surgical stapling device platform |
US7931660B2 (en) | 2007-05-10 | 2011-04-26 | Tyco Healthcare Group Lp | Powered tacker instrument |
US7905380B2 (en) | 2007-06-04 | 2011-03-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a multiple rate directional switching mechanism |
US8931682B2 (en) | 2007-06-04 | 2015-01-13 | Ethicon Endo-Surgery, Inc. | Robotically-controlled shaft based rotary drive systems for surgical instruments |
US11672531B2 (en) | 2007-06-04 | 2023-06-13 | Cilag Gmbh International | Rotary drive systems for surgical instruments |
US8534528B2 (en) | 2007-06-04 | 2013-09-17 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a multiple rate directional switching mechanism |
US7832408B2 (en) | 2007-06-04 | 2010-11-16 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a directional switching mechanism |
US7753245B2 (en) | 2007-06-22 | 2010-07-13 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments |
US8308040B2 (en) | 2007-06-22 | 2012-11-13 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with an articulatable end effector |
US11849941B2 (en) | 2007-06-29 | 2023-12-26 | Cilag Gmbh International | Staple cartridge having staple cavities extending at a transverse angle relative to a longitudinal cartridge axis |
US8523889B2 (en) | 2007-07-27 | 2013-09-03 | Ethicon Endo-Surgery, Inc. | Ultrasonic end effectors with increased active length |
US8808319B2 (en) | 2007-07-27 | 2014-08-19 | Ethicon Endo-Surgery, Inc. | Surgical instruments |
US8430898B2 (en) | 2007-07-31 | 2013-04-30 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
US9044261B2 (en) | 2007-07-31 | 2015-06-02 | Ethicon Endo-Surgery, Inc. | Temperature controlled ultrasonic surgical instruments |
US8512365B2 (en) | 2007-07-31 | 2013-08-20 | Ethicon Endo-Surgery, Inc. | Surgical instruments |
US7877853B2 (en) | 2007-09-20 | 2011-02-01 | Tyco Healthcare Group Lp | Method of manufacturing end effector assembly for sealing tissue |
US7877852B2 (en) | 2007-09-20 | 2011-02-01 | Tyco Healthcare Group Lp | Method of manufacturing an end effector assembly for sealing tissue |
AU2008221509B2 (en) | 2007-09-28 | 2013-10-10 | Covidien Lp | Dual durometer insulating boot for electrosurgical forceps |
US8251996B2 (en) | 2007-09-28 | 2012-08-28 | Tyco Healthcare Group Lp | Insulating sheath for electrosurgical forceps |
US9023043B2 (en) | 2007-09-28 | 2015-05-05 | Covidien Lp | Insulating mechanically-interfaced boot and jaws for electrosurgical forceps |
US8623027B2 (en) | 2007-10-05 | 2014-01-07 | Ethicon Endo-Surgery, Inc. | Ergonomic surgical instruments |
US7922063B2 (en) | 2007-10-31 | 2011-04-12 | Tyco Healthcare Group, Lp | Powered surgical instrument |
US10010339B2 (en) | 2007-11-30 | 2018-07-03 | Ethicon Llc | Ultrasonic surgical blades |
US8764748B2 (en) | 2008-02-06 | 2014-07-01 | Covidien Lp | End effector assembly for electrosurgical device and method for making the same |
US8870867B2 (en) | 2008-02-06 | 2014-10-28 | Aesculap Ag | Articulable electrosurgical instrument with a stabilizable articulation actuator |
US7905381B2 (en) | 2008-09-19 | 2011-03-15 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with cutting member arrangement |
US8561870B2 (en) | 2008-02-13 | 2013-10-22 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument |
US8622274B2 (en) | 2008-02-14 | 2014-01-07 | Ethicon Endo-Surgery, Inc. | Motorized cutting and fastening instrument having control circuit for optimizing battery usage |
US8758391B2 (en) | 2008-02-14 | 2014-06-24 | Ethicon Endo-Surgery, Inc. | Interchangeable tools for surgical instruments |
US7819298B2 (en) | 2008-02-14 | 2010-10-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with control features operable with one hand |
US8573465B2 (en) | 2008-02-14 | 2013-11-05 | Ethicon Endo-Surgery, Inc. | Robotically-controlled surgical end effector system with rotary actuated closure systems |
US8636736B2 (en) | 2008-02-14 | 2014-01-28 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument |
US8752749B2 (en) | 2008-02-14 | 2014-06-17 | Ethicon Endo-Surgery, Inc. | Robotically-controlled disposable motor-driven loading unit |
US8584919B2 (en) | 2008-02-14 | 2013-11-19 | Ethicon Endo-Sugery, Inc. | Surgical stapling apparatus with load-sensitive firing mechanism |
US7866527B2 (en) | 2008-02-14 | 2011-01-11 | Ethicon Endo-Surgery, Inc. | Surgical stapling apparatus with interlockable firing system |
US8657174B2 (en) | 2008-02-14 | 2014-02-25 | Ethicon Endo-Surgery, Inc. | Motorized surgical cutting and fastening instrument having handle based power source |
US7793812B2 (en) | 2008-02-14 | 2010-09-14 | Ethicon Endo-Surgery, Inc. | Disposable motor-driven loading unit for use with a surgical cutting and stapling apparatus |
US8459525B2 (en) | 2008-02-14 | 2013-06-11 | Ethicon Endo-Sugery, Inc. | Motorized surgical cutting and fastening instrument having a magnetic drive train torque limiting device |
BRPI0901282A2 (en) | 2008-02-14 | 2009-11-17 | Ethicon Endo Surgery Inc | surgical cutting and fixation instrument with rf electrodes |
US9179912B2 (en) | 2008-02-14 | 2015-11-10 | Ethicon Endo-Surgery, Inc. | Robotically-controlled motorized surgical cutting and fastening instrument |
US11272927B2 (en) | 2008-02-15 | 2022-03-15 | Cilag Gmbh International | Layer arrangements for surgical staple cartridges |
US8623276B2 (en) | 2008-02-15 | 2014-01-07 | Covidien Lp | Method and system for sterilizing an electrosurgical instrument |
US9615826B2 (en) | 2010-09-30 | 2017-04-11 | Ethicon Endo-Surgery, Llc | Multiple thickness implantable layers for surgical stapling devices |
US8028884B2 (en) | 2008-04-22 | 2011-10-04 | Tyco Healthcare Group Lp | Cartridge for applying varying amounts of tissue compression |
US8357158B2 (en) | 2008-04-22 | 2013-01-22 | Covidien Lp | Jaw closure detection system |
US8348947B2 (en) | 2008-04-25 | 2013-01-08 | Olympus Medical Systems Corp. | Treatment system, and treatment method for living tissue using energy |
US8469956B2 (en) | 2008-07-21 | 2013-06-25 | Covidien Lp | Variable resistor jaw |
US9089360B2 (en) | 2008-08-06 | 2015-07-28 | Ethicon Endo-Surgery, Inc. | Devices and techniques for cutting and coagulating tissue |
US8162973B2 (en) * | 2008-08-15 | 2012-04-24 | Tyco Healthcare Group Lp | Method of transferring pressure in an articulating surgical instrument |
US8257387B2 (en) | 2008-08-15 | 2012-09-04 | Tyco Healthcare Group Lp | Method of transferring pressure in an articulating surgical instrument |
US9603652B2 (en) | 2008-08-21 | 2017-03-28 | Covidien Lp | Electrosurgical instrument including a sensor |
US8317787B2 (en) | 2008-08-28 | 2012-11-27 | Covidien Lp | Tissue fusion jaw angle improvement |
US8784417B2 (en) | 2008-08-28 | 2014-07-22 | Covidien Lp | Tissue fusion jaw angle improvement |
US8795274B2 (en) | 2008-08-28 | 2014-08-05 | Covidien Lp | Tissue fusion jaw angle improvement |
US8113405B2 (en) | 2008-09-03 | 2012-02-14 | Tyco Healthcare Group, Lp | Surgical instrument with indicator |
US20100051668A1 (en) * | 2008-09-03 | 2010-03-04 | Milliman Keith L | Surgical instrument with indicator |
US8303582B2 (en) | 2008-09-15 | 2012-11-06 | Tyco Healthcare Group Lp | Electrosurgical instrument having a coated electrode utilizing an atomic layer deposition technique |
US7837080B2 (en) | 2008-09-18 | 2010-11-23 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with device for indicating when the instrument has cut through tissue |
US20100069903A1 (en) | 2008-09-18 | 2010-03-18 | Tyco Healthcare Group Lp | Vessel Sealing Instrument With Cutting Mechanism |
PL3476312T3 (en) | 2008-09-19 | 2024-03-11 | Ethicon Llc | Surgical stapler with apparatus for adjusting staple height |
US11648005B2 (en) | 2008-09-23 | 2023-05-16 | Cilag Gmbh International | Robotically-controlled motorized surgical instrument with an end effector |
US8210411B2 (en) | 2008-09-23 | 2012-07-03 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument |
US9386983B2 (en) | 2008-09-23 | 2016-07-12 | Ethicon Endo-Surgery, Llc | Robotically-controlled motorized surgical instrument |
US9050083B2 (en) | 2008-09-23 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Motorized surgical instrument |
US9005230B2 (en) | 2008-09-23 | 2015-04-14 | Ethicon Endo-Surgery, Inc. | Motorized surgical instrument |
US9375254B2 (en) | 2008-09-25 | 2016-06-28 | Covidien Lp | Seal and separate algorithm |
US8535312B2 (en) | 2008-09-25 | 2013-09-17 | Covidien Lp | Apparatus, system and method for performing an electrosurgical procedure |
US8968314B2 (en) | 2008-09-25 | 2015-03-03 | Covidien Lp | Apparatus, system and method for performing an electrosurgical procedure |
US8142473B2 (en) | 2008-10-03 | 2012-03-27 | Tyco Healthcare Group Lp | Method of transferring rotational motion in an articulating surgical instrument |
US8469957B2 (en) | 2008-10-07 | 2013-06-25 | Covidien Lp | Apparatus, system, and method for performing an electrosurgical procedure |
US8636761B2 (en) | 2008-10-09 | 2014-01-28 | Covidien Lp | Apparatus, system, and method for performing an endoscopic electrosurgical procedure |
US8016827B2 (en) | 2008-10-09 | 2011-09-13 | Tyco Healthcare Group Lp | Apparatus, system, and method for performing an electrosurgical procedure |
US8608045B2 (en) | 2008-10-10 | 2013-12-17 | Ethicon Endo-Sugery, Inc. | Powered surgical cutting and stapling apparatus with manually retractable firing system |
US8486107B2 (en) | 2008-10-20 | 2013-07-16 | Covidien Lp | Method of sealing tissue using radiofrequency energy |
US8197479B2 (en) | 2008-12-10 | 2012-06-12 | Tyco Healthcare Group Lp | Vessel sealer and divider |
US8114122B2 (en) | 2009-01-13 | 2012-02-14 | Tyco Healthcare Group Lp | Apparatus, system, and method for performing an electrosurgical procedure |
US8414577B2 (en) | 2009-02-05 | 2013-04-09 | Ethicon Endo-Surgery, Inc. | Surgical instruments and components for use in sterile environments |
US8517239B2 (en) | 2009-02-05 | 2013-08-27 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument comprising a magnetic element driver |
US8397971B2 (en) | 2009-02-05 | 2013-03-19 | Ethicon Endo-Surgery, Inc. | Sterilizable surgical instrument |
JP2012517287A (en) | 2009-02-06 | 2012-08-02 | エシコン・エンド−サージェリィ・インコーポレイテッド | Improvement of driven surgical stapler |
US8444036B2 (en) | 2009-02-06 | 2013-05-21 | Ethicon Endo-Surgery, Inc. | Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector |
US8187273B2 (en) | 2009-05-07 | 2012-05-29 | Tyco Healthcare Group Lp | Apparatus, system, and method for performing an electrosurgical procedure |
US9700339B2 (en) | 2009-05-20 | 2017-07-11 | Ethicon Endo-Surgery, Inc. | Coupling arrangements and methods for attaching tools to ultrasonic surgical instruments |
US8821514B2 (en) | 2009-06-08 | 2014-09-02 | Covidien Lp | Powered tack applier |
US8246618B2 (en) | 2009-07-08 | 2012-08-21 | Tyco Healthcare Group Lp | Electrosurgical jaws with offset knife |
US8663220B2 (en) | 2009-07-15 | 2014-03-04 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments |
US8955732B2 (en) * | 2009-08-11 | 2015-02-17 | Covidien Lp | Surgical stapling apparatus |
US8430876B2 (en) | 2009-08-27 | 2013-04-30 | Tyco Healthcare Group Lp | Vessel sealer and divider with knife lockout |
US8357159B2 (en) | 2009-09-03 | 2013-01-22 | Covidien Lp | Open vessel sealing instrument with pivot assembly |
US8133254B2 (en) | 2009-09-18 | 2012-03-13 | Tyco Healthcare Group Lp | In vivo attachable and detachable end effector assembly and laparoscopic surgical instrument and methods therefor |
US8112871B2 (en) | 2009-09-28 | 2012-02-14 | Tyco Healthcare Group Lp | Method for manufacturing electrosurgical seal plates |
US9024237B2 (en) | 2009-09-29 | 2015-05-05 | Covidien Lp | Material fusing apparatus, system and method of use |
US8512371B2 (en) | 2009-10-06 | 2013-08-20 | Covidien Lp | Jaw, blade and gap manufacturing for surgical instruments with small jaws |
US8292886B2 (en) | 2009-10-06 | 2012-10-23 | Tyco Healthcare Group Lp | Apparatus, system, and method for performing an electrosurgical procedure |
US10441345B2 (en) | 2009-10-09 | 2019-10-15 | Ethicon Llc | Surgical generator for ultrasonic and electrosurgical devices |
US8939974B2 (en) | 2009-10-09 | 2015-01-27 | Ethicon Endo-Surgery, Inc. | Surgical instrument comprising first and second drive systems actuatable by a common trigger mechanism |
US8747404B2 (en) | 2009-10-09 | 2014-06-10 | Ethicon Endo-Surgery, Inc. | Surgical instrument for transmitting energy to tissue comprising non-conductive grasping portions |
US8574231B2 (en) | 2009-10-09 | 2013-11-05 | Ethicon Endo-Surgery, Inc. | Surgical instrument for transmitting energy to tissue comprising a movable electrode or insulator |
US8951248B2 (en) | 2009-10-09 | 2015-02-10 | Ethicon Endo-Surgery, Inc. | Surgical generator for ultrasonic and electrosurgical devices |
US10172669B2 (en) | 2009-10-09 | 2019-01-08 | Ethicon Llc | Surgical instrument comprising an energy trigger lockout |
US8906016B2 (en) | 2009-10-09 | 2014-12-09 | Ethicon Endo-Surgery, Inc. | Surgical instrument for transmitting energy to tissue comprising steam control paths |
US11090104B2 (en) | 2009-10-09 | 2021-08-17 | Cilag Gmbh International | Surgical generator for ultrasonic and electrosurgical devices |
US8851354B2 (en) | 2009-12-24 | 2014-10-07 | Ethicon Endo-Surgery, Inc. | Surgical cutting instrument that analyzes tissue thickness |
US8220688B2 (en) | 2009-12-24 | 2012-07-17 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument with electric actuator directional control assembly |
US8561871B2 (en) | 2009-12-31 | 2013-10-22 | Covidien Lp | Indicators for surgical staplers |
US8714430B2 (en) | 2009-12-31 | 2014-05-06 | Covidien Lp | Indicator for surgical stapler |
US8480671B2 (en) | 2010-01-22 | 2013-07-09 | Covidien Lp | Compact jaw including split pivot pin |
US8556929B2 (en) | 2010-01-29 | 2013-10-15 | Covidien Lp | Surgical forceps capable of adjusting seal plate width based on vessel size |
KR20120139661A (en) | 2010-02-04 | 2012-12-27 | 아에스쿨랍 아게 | Laparoscopic radiofrequency surgical device |
US8486096B2 (en) | 2010-02-11 | 2013-07-16 | Ethicon Endo-Surgery, Inc. | Dual purpose surgical instrument for cutting and coagulating tissue |
US8469981B2 (en) | 2010-02-11 | 2013-06-25 | Ethicon Endo-Surgery, Inc. | Rotatable cutting implement arrangements for ultrasonic surgical instruments |
US8951272B2 (en) | 2010-02-11 | 2015-02-10 | Ethicon Endo-Surgery, Inc. | Seal arrangements for ultrasonically powered surgical instruments |
US8827992B2 (en) | 2010-03-26 | 2014-09-09 | Aesculap Ag | Impedance mediated control of power delivery for electrosurgery |
US8696665B2 (en) | 2010-03-26 | 2014-04-15 | Ethicon Endo-Surgery, Inc. | Surgical cutting and sealing instrument with reduced firing force |
US8419727B2 (en) | 2010-03-26 | 2013-04-16 | Aesculap Ag | Impedance mediated power delivery for electrosurgery |
JP2011212315A (en) * | 2010-03-31 | 2011-10-27 | Fujifilm Corp | High frequency treatment instrument for endoscope |
US8597295B2 (en) | 2010-04-12 | 2013-12-03 | Covidien Lp | Surgical instrument with non-contact electrical coupling |
US8496682B2 (en) | 2010-04-12 | 2013-07-30 | Ethicon Endo-Surgery, Inc. | Electrosurgical cutting and sealing instruments with cam-actuated jaws |
US8834518B2 (en) | 2010-04-12 | 2014-09-16 | Ethicon Endo-Surgery, Inc. | Electrosurgical cutting and sealing instruments with cam-actuated jaws |
US8709035B2 (en) | 2010-04-12 | 2014-04-29 | Ethicon Endo-Surgery, Inc. | Electrosurgical cutting and sealing instruments with jaws having a parallel closure motion |
US8535311B2 (en) | 2010-04-22 | 2013-09-17 | Ethicon Endo-Surgery, Inc. | Electrosurgical instrument comprising closing and firing systems |
US8439913B2 (en) | 2010-04-29 | 2013-05-14 | Covidien Lp | Pressure sensing sealing plate |
US8685020B2 (en) | 2010-05-17 | 2014-04-01 | Ethicon Endo-Surgery, Inc. | Surgical instruments and end effectors therefor |
GB2480498A (en) | 2010-05-21 | 2011-11-23 | Ethicon Endo Surgery Inc | Medical device comprising RF circuitry |
US8491624B2 (en) | 2010-06-02 | 2013-07-23 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8430877B2 (en) | 2010-06-02 | 2013-04-30 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8409247B2 (en) | 2010-06-02 | 2013-04-02 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8409246B2 (en) | 2010-06-02 | 2013-04-02 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8469991B2 (en) | 2010-06-02 | 2013-06-25 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8888776B2 (en) | 2010-06-09 | 2014-11-18 | Ethicon Endo-Surgery, Inc. | Electrosurgical instrument employing an electrode |
US8753338B2 (en) | 2010-06-10 | 2014-06-17 | Ethicon Endo-Surgery, Inc. | Electrosurgical instrument employing a thermal management system |
US9005199B2 (en) | 2010-06-10 | 2015-04-14 | Ethicon Endo-Surgery, Inc. | Heat management configurations for controlling heat dissipation from electrosurgical instruments |
US8764747B2 (en) | 2010-06-10 | 2014-07-01 | Ethicon Endo-Surgery, Inc. | Electrosurgical instrument comprising sequentially activated electrodes |
US8453906B2 (en) | 2010-07-14 | 2013-06-04 | Ethicon Endo-Surgery, Inc. | Surgical instruments with electrodes |
US8613383B2 (en) * | 2010-07-14 | 2013-12-24 | Ethicon Endo-Surgery, Inc. | Surgical instruments with electrodes |
US8795327B2 (en) | 2010-07-22 | 2014-08-05 | Ethicon Endo-Surgery, Inc. | Electrosurgical instrument with separate closure and cutting members |
US8979843B2 (en) | 2010-07-23 | 2015-03-17 | Ethicon Endo-Surgery, Inc. | Electrosurgical cutting and sealing instrument |
US9192431B2 (en) | 2010-07-23 | 2015-11-24 | Ethicon Endo-Surgery, Inc. | Electrosurgical cutting and sealing instrument |
US9011437B2 (en) | 2010-07-23 | 2015-04-21 | Ethicon Endo-Surgery, Inc. | Electrosurgical cutting and sealing instrument |
US8783543B2 (en) | 2010-07-30 | 2014-07-22 | Ethicon Endo-Surgery, Inc. | Tissue acquisition arrangements and methods for surgical stapling devices |
US8298233B2 (en) | 2010-08-20 | 2012-10-30 | Tyco Healthcare Group Lp | Surgical instrument configured for use with interchangeable hand grips |
US8814864B2 (en) | 2010-08-23 | 2014-08-26 | Covidien Lp | Method of manufacturing tissue sealing electrodes |
US8360296B2 (en) | 2010-09-09 | 2013-01-29 | Ethicon Endo-Surgery, Inc. | Surgical stapling head assembly with firing lockout for a surgical stapler |
US9289212B2 (en) | 2010-09-17 | 2016-03-22 | Ethicon Endo-Surgery, Inc. | Surgical instruments and batteries for surgical instruments |
US9173698B2 (en) | 2010-09-17 | 2015-11-03 | Aesculap Ag | Electrosurgical tissue sealing augmented with a seal-enhancing composition |
US8632525B2 (en) | 2010-09-17 | 2014-01-21 | Ethicon Endo-Surgery, Inc. | Power control arrangements for surgical instruments and batteries |
US20120078244A1 (en) | 2010-09-24 | 2012-03-29 | Worrell Barry C | Control features for articulating surgical device |
US9204880B2 (en) | 2012-03-28 | 2015-12-08 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising capsules defining a low pressure environment |
US11925354B2 (en) | 2010-09-30 | 2024-03-12 | Cilag Gmbh International | Staple cartridge comprising staples positioned within a compressible portion thereof |
CA2812553C (en) | 2010-09-30 | 2019-02-12 | Ethicon Endo-Surgery, Inc. | Fastener system comprising a retention matrix and an alignment matrix |
US20120080498A1 (en) | 2010-09-30 | 2012-04-05 | Ethicon Endo-Surgery, Inc. | Curved end effector for a stapling instrument |
US9629814B2 (en) | 2010-09-30 | 2017-04-25 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator configured to redistribute compressive forces |
US9351730B2 (en) | 2011-04-29 | 2016-05-31 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator comprising channels |
US11812965B2 (en) | 2010-09-30 | 2023-11-14 | Cilag Gmbh International | Layer of material for a surgical end effector |
US11298125B2 (en) | 2010-09-30 | 2022-04-12 | Cilag Gmbh International | Tissue stapler having a thickness compensator |
US10945731B2 (en) | 2010-09-30 | 2021-03-16 | Ethicon Llc | Tissue thickness compensator comprising controlled release and expansion |
US9220501B2 (en) | 2010-09-30 | 2015-12-29 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensators |
US9232941B2 (en) | 2010-09-30 | 2016-01-12 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising a reservoir |
US9314246B2 (en) | 2010-09-30 | 2016-04-19 | Ethicon Endo-Surgery, Llc | Tissue stapler having a thickness compensator incorporating an anti-inflammatory agent |
US9332974B2 (en) | 2010-09-30 | 2016-05-10 | Ethicon Endo-Surgery, Llc | Layered tissue thickness compensator |
US9386988B2 (en) | 2010-09-30 | 2016-07-12 | Ethicon End-Surgery, LLC | Retainer assembly including a tissue thickness compensator |
US9364233B2 (en) | 2010-09-30 | 2016-06-14 | Ethicon Endo-Surgery, Llc | Tissue thickness compensators for circular surgical staplers |
US9414838B2 (en) | 2012-03-28 | 2016-08-16 | Ethicon Endo-Surgery, Llc | Tissue thickness compensator comprised of a plurality of materials |
US9220500B2 (en) | 2010-09-30 | 2015-12-29 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator comprising structure to produce a resilient load |
US9700317B2 (en) | 2010-09-30 | 2017-07-11 | Ethicon Endo-Surgery, Llc | Fastener cartridge comprising a releasable tissue thickness compensator |
US8893949B2 (en) | 2010-09-30 | 2014-11-25 | Ethicon Endo-Surgery, Inc. | Surgical stapler with floating anvil |
US9113865B2 (en) | 2010-09-30 | 2015-08-25 | Ethicon Endo-Surgery, Inc. | Staple cartridge comprising a layer |
US9307989B2 (en) | 2012-03-28 | 2016-04-12 | Ethicon Endo-Surgery, Llc | Tissue stapler having a thickness compensator incorportating a hydrophobic agent |
US8979890B2 (en) | 2010-10-01 | 2015-03-17 | Ethicon Endo-Surgery, Inc. | Surgical instrument with jaw member |
US8695866B2 (en) | 2010-10-01 | 2014-04-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a power control circuit |
US9345534B2 (en) | 2010-10-04 | 2016-05-24 | Covidien Lp | Vessel sealing instrument |
US8628529B2 (en) | 2010-10-26 | 2014-01-14 | Ethicon Endo-Surgery, Inc. | Surgical instrument with magnetic clamping force |
US8715277B2 (en) | 2010-12-08 | 2014-05-06 | Ethicon Endo-Surgery, Inc. | Control of jaw compression in surgical instrument having end effector with opposing jaw members |
US9113940B2 (en) | 2011-01-14 | 2015-08-25 | Covidien Lp | Trigger lockout and kickback mechanism for surgical instruments |
US8496157B2 (en) | 2011-02-18 | 2013-07-30 | Covidien Lp | Tilting anvil for annular surgical stapler |
USD661394S1 (en) | 2011-02-24 | 2012-06-05 | Tyco Healthcare Group Lp | Device jaw |
US10413349B2 (en) | 2011-03-04 | 2019-09-17 | Covidien Lp | System and methods for identifying tissue and vessels |
US8632462B2 (en) | 2011-03-14 | 2014-01-21 | Ethicon Endo-Surgery, Inc. | Trans-rectum universal ports |
US8568408B2 (en) | 2011-04-21 | 2013-10-29 | Covidien Lp | Surgical forceps |
AU2012250197B2 (en) | 2011-04-29 | 2017-08-10 | Ethicon Endo-Surgery, Inc. | Staple cartridge comprising staples positioned within a compressible portion thereof |
US8900232B2 (en) | 2011-05-06 | 2014-12-02 | Covidien Lp | Bifurcated shaft for surgical instrument |
US8939972B2 (en) | 2011-05-06 | 2015-01-27 | Covidien Lp | Surgical forceps |
US9456870B2 (en) | 2011-05-16 | 2016-10-04 | Covidien Lp | Optical energy-based methods and apparatus for tissue sealing |
US8685009B2 (en) | 2011-05-16 | 2014-04-01 | Covidien Lp | Thread-like knife for tissue cutting |
US9113934B2 (en) | 2011-05-16 | 2015-08-25 | Covidien Lp | Optical energy-based methods and apparatus for tissue sealing |
US9113933B2 (en) | 2011-05-16 | 2015-08-25 | Covidien Lp | Optical energy-based methods and apparatus for tissue sealing |
US10117705B2 (en) | 2011-05-16 | 2018-11-06 | Covidien Lp | Optical recognition of tissue and vessels |
US9265568B2 (en) | 2011-05-16 | 2016-02-23 | Coviden Lp | Destruction of vessel walls for energy-based vessel sealing enhancement |
US8852185B2 (en) | 2011-05-19 | 2014-10-07 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US8968283B2 (en) | 2011-05-19 | 2015-03-03 | Covidien Lp | Ultrasound device for precise tissue sealing and blade-less cutting |
US9161807B2 (en) | 2011-05-23 | 2015-10-20 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US9072535B2 (en) | 2011-05-27 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments with rotatable staple deployment arrangements |
US11207064B2 (en) | 2011-05-27 | 2021-12-28 | Cilag Gmbh International | Automated end effector component reloading system for use with a robotic system |
US9358065B2 (en) * | 2011-06-23 | 2016-06-07 | Covidien Lp | Shaped electrode bipolar resection apparatus, system and methods of use |
US8702749B2 (en) | 2011-06-09 | 2014-04-22 | Covidien Lp | Lever latch assemblies for vessel sealer and divider |
US9615877B2 (en) | 2011-06-17 | 2017-04-11 | Covidien Lp | Tissue sealing forceps |
US9039704B2 (en) | 2011-06-22 | 2015-05-26 | Covidien Lp | Forceps |
US9339327B2 (en) | 2011-06-28 | 2016-05-17 | Aesculap Ag | Electrosurgical tissue dissecting device |
US8745840B2 (en) | 2011-07-11 | 2014-06-10 | Covidien Lp | Surgical forceps and method of manufacturing thereof |
US9844384B2 (en) | 2011-07-11 | 2017-12-19 | Covidien Lp | Stand alone energy-based tissue clips |
US8628557B2 (en) | 2011-07-11 | 2014-01-14 | Covidien Lp | Surgical forceps |
US9039732B2 (en) | 2011-07-11 | 2015-05-26 | Covidien Lp | Surgical forceps |
US9259265B2 (en) | 2011-07-22 | 2016-02-16 | Ethicon Endo-Surgery, Llc | Surgical instruments for tensioning tissue |
US8702737B2 (en) | 2011-08-08 | 2014-04-22 | Covidien Lp | Surgical forceps |
US8852186B2 (en) | 2011-08-09 | 2014-10-07 | Covidien Lp | Microwave sensing for tissue sealing |
US8968306B2 (en) | 2011-08-09 | 2015-03-03 | Covidien Lp | Surgical forceps |
US8968307B2 (en) | 2011-08-18 | 2015-03-03 | Covidien Lp | Surgical forceps |
US8968317B2 (en) | 2011-08-18 | 2015-03-03 | Covidien Lp | Surgical forceps |
US9028492B2 (en) | 2011-08-18 | 2015-05-12 | Covidien Lp | Surgical instruments with removable components |
US8685056B2 (en) | 2011-08-18 | 2014-04-01 | Covidien Lp | Surgical forceps |
US9044243B2 (en) | 2011-08-30 | 2015-06-02 | Ethcon Endo-Surgery, Inc. | Surgical cutting and fastening device with descendible second trigger arrangement |
US9113909B2 (en) | 2011-09-01 | 2015-08-25 | Covidien Lp | Surgical vessel sealer and divider |
US9113938B2 (en) | 2011-09-09 | 2015-08-25 | Covidien Lp | Apparatus for performing electrosurgical procedures having a spring mechanism associated with the jaw members |
US8679098B2 (en) | 2011-09-13 | 2014-03-25 | Covidien Lp | Rotation knobs for surgical instruments |
US8845636B2 (en) | 2011-09-16 | 2014-09-30 | Covidien Lp | Seal plate with insulation displacement connection |
US9636169B2 (en) | 2011-09-19 | 2017-05-02 | Covidien Lp | Electrosurgical instrument |
US9050084B2 (en) | 2011-09-23 | 2015-06-09 | Ethicon Endo-Surgery, Inc. | Staple cartridge including collapsible deck arrangement |
US8961515B2 (en) | 2011-09-28 | 2015-02-24 | Covidien Lp | Electrosurgical instrument |
US9486220B2 (en) * | 2011-09-28 | 2016-11-08 | Covidien Lp | Surgical tissue occluding device |
US9668806B2 (en) | 2011-09-29 | 2017-06-06 | Covidien Lp | Surgical forceps including a removable stop member |
US9060780B2 (en) | 2011-09-29 | 2015-06-23 | Covidien Lp | Methods of manufacturing shafts for surgical instruments |
US8756785B2 (en) | 2011-09-29 | 2014-06-24 | Covidien Lp | Surgical instrument shafts and methods of manufacturing shafts for surgical instruments |
US8864795B2 (en) | 2011-10-03 | 2014-10-21 | Covidien Lp | Surgical forceps |
US9492221B2 (en) | 2011-10-20 | 2016-11-15 | Covidien Lp | Dissection scissors on surgical device |
US8968308B2 (en) | 2011-10-20 | 2015-03-03 | Covidien Lp | Multi-circuit seal plates |
US9314295B2 (en) | 2011-10-20 | 2016-04-19 | Covidien Lp | Dissection scissors on surgical device |
US9333025B2 (en) | 2011-10-24 | 2016-05-10 | Ethicon Endo-Surgery, Llc | Battery initialization clip |
US8968309B2 (en) | 2011-11-10 | 2015-03-03 | Covidien Lp | Surgical forceps |
US9265565B2 (en) | 2011-11-29 | 2016-02-23 | Covidien Lp | Open vessel sealing instrument and method of manufacturing the same |
US9113899B2 (en) | 2011-11-29 | 2015-08-25 | Covidien Lp | Coupling mechanisms for surgical instruments |
US8968310B2 (en) | 2011-11-30 | 2015-03-03 | Covidien Lp | Electrosurgical instrument with a knife blade lockout mechanism |
US9259268B2 (en) | 2011-12-06 | 2016-02-16 | Covidien Lp | Vessel sealing using microwave energy |
US8864753B2 (en) | 2011-12-13 | 2014-10-21 | Covidien Lp | Surgical Forceps Connected to Treatment Light Source |
US9023035B2 (en) | 2012-01-06 | 2015-05-05 | Covidien Lp | Monopolar pencil with integrated bipolar/ligasure tweezers |
USD680220S1 (en) | 2012-01-12 | 2013-04-16 | Coviden IP | Slider handle for laparoscopic device |
US9113897B2 (en) | 2012-01-23 | 2015-08-25 | Covidien Lp | Partitioned surgical instrument |
US9113882B2 (en) | 2012-01-23 | 2015-08-25 | Covidien Lp | Method of manufacturing an electrosurgical instrument |
US8968360B2 (en) | 2012-01-25 | 2015-03-03 | Covidien Lp | Surgical instrument with resilient driving member and related methods of use |
US8961513B2 (en) | 2012-01-25 | 2015-02-24 | Covidien Lp | Surgical tissue sealer |
US9693816B2 (en) | 2012-01-30 | 2017-07-04 | Covidien Lp | Electrosurgical apparatus with integrated energy sensing at tissue site |
EP2811932B1 (en) | 2012-02-10 | 2019-06-26 | Ethicon LLC | Robotically controlled surgical instrument |
US9044230B2 (en) | 2012-02-13 | 2015-06-02 | Ethicon Endo-Surgery, Inc. | Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status |
US8747434B2 (en) | 2012-02-20 | 2014-06-10 | Covidien Lp | Knife deployment mechanisms for surgical forceps |
US8887373B2 (en) | 2012-02-24 | 2014-11-18 | Covidien Lp | Vessel sealing instrument with reduced thermal spread and method of manufacture therefor |
US9011435B2 (en) | 2012-02-24 | 2015-04-21 | Covidien Lp | Method for manufacturing vessel sealing instrument with reduced thermal spread |
US8961514B2 (en) | 2012-03-06 | 2015-02-24 | Covidien Lp | Articulating surgical apparatus |
US8752264B2 (en) | 2012-03-06 | 2014-06-17 | Covidien Lp | Surgical tissue sealer |
US8968298B2 (en) | 2012-03-15 | 2015-03-03 | Covidien Lp | Electrosurgical instrument |
US9375282B2 (en) | 2012-03-26 | 2016-06-28 | Covidien Lp | Light energy sealing, cutting and sensing surgical device |
BR112014024098B1 (en) | 2012-03-28 | 2021-05-25 | Ethicon Endo-Surgery, Inc. | staple cartridge |
RU2644272C2 (en) | 2012-03-28 | 2018-02-08 | Этикон Эндо-Серджери, Инк. | Limitation node with tissue thickness compensator |
JP6305979B2 (en) | 2012-03-28 | 2018-04-04 | エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. | Tissue thickness compensator with multiple layers |
US9198662B2 (en) | 2012-03-28 | 2015-12-01 | Ethicon Endo-Surgery, Inc. | Tissue thickness compensator having improved visibility |
US9265569B2 (en) | 2012-03-29 | 2016-02-23 | Covidien Lp | Method of manufacturing an electrosurgical forceps |
US9439668B2 (en) | 2012-04-09 | 2016-09-13 | Ethicon Endo-Surgery, Llc | Switch arrangements for ultrasonic surgical instruments |
US10966780B2 (en) | 2012-04-17 | 2021-04-06 | Covidien Lp | Electrosurgical instrument having a coated electrode |
US9713493B2 (en) | 2012-04-30 | 2017-07-25 | Covidien Lp | Method of switching energy modality on a cordless RF device |
US8968311B2 (en) | 2012-05-01 | 2015-03-03 | Covidien Lp | Surgical instrument with stamped double-flag jaws and actuation mechanism |
US8920461B2 (en) | 2012-05-01 | 2014-12-30 | Covidien Lp | Surgical forceps with bifurcated flanged jaw components |
US9668807B2 (en) | 2012-05-01 | 2017-06-06 | Covidien Lp | Simplified spring load mechanism for delivering shaft force of a surgical instrument |
US9034009B2 (en) | 2012-05-01 | 2015-05-19 | Covidien Lp | Surgical forceps |
US9820765B2 (en) | 2012-05-01 | 2017-11-21 | Covidien Lp | Surgical instrument with stamped double-flange jaws |
US9039731B2 (en) | 2012-05-08 | 2015-05-26 | Covidien Lp | Surgical forceps including blade safety mechanism |
US9375258B2 (en) | 2012-05-08 | 2016-06-28 | Covidien Lp | Surgical forceps |
US9113901B2 (en) | 2012-05-14 | 2015-08-25 | Covidien Lp | Modular surgical instrument with contained electrical or mechanical systems |
US9192432B2 (en) | 2012-05-29 | 2015-11-24 | Covidien Lp | Lever latch assemblies for surgical improvements |
US8679140B2 (en) | 2012-05-30 | 2014-03-25 | Covidien Lp | Surgical clamping device with ratcheting grip lock |
US8968313B2 (en) | 2012-06-12 | 2015-03-03 | Covidien Lp | Electrosurgical instrument with a knife blade stop |
US9101358B2 (en) | 2012-06-15 | 2015-08-11 | Ethicon Endo-Surgery, Inc. | Articulatable surgical instrument comprising a firing drive |
US9011436B2 (en) | 2012-06-26 | 2015-04-21 | Covidien Lp | Double-length jaw system for electrosurgical instrument |
US9770255B2 (en) | 2012-06-26 | 2017-09-26 | Covidien Lp | One-piece handle assembly |
US9510891B2 (en) | 2012-06-26 | 2016-12-06 | Covidien Lp | Surgical instruments with structures to provide access for cleaning |
US9125662B2 (en) | 2012-06-28 | 2015-09-08 | Ethicon Endo-Surgery, Inc. | Multi-axis articulating and rotating surgical tools |
US11202631B2 (en) | 2012-06-28 | 2021-12-21 | Cilag Gmbh International | Stapling assembly comprising a firing lockout |
US9072536B2 (en) | 2012-06-28 | 2015-07-07 | Ethicon Endo-Surgery, Inc. | Differential locking arrangements for rotary powered surgical instruments |
JP6290201B2 (en) | 2012-06-28 | 2018-03-07 | エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. | Lockout for empty clip cartridge |
US8747238B2 (en) | 2012-06-28 | 2014-06-10 | Ethicon Endo-Surgery, Inc. | Rotary drive shaft assemblies for surgical instruments with articulatable end effectors |
US9408606B2 (en) | 2012-06-28 | 2016-08-09 | Ethicon Endo-Surgery, Llc | Robotically powered surgical device with manually-actuatable reversing system |
US20140005640A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Surgical end effector jaw and electrode configurations |
US9119657B2 (en) | 2012-06-28 | 2015-09-01 | Ethicon Endo-Surgery, Inc. | Rotary actuatable closure arrangement for surgical end effector |
US9204879B2 (en) | 2012-06-28 | 2015-12-08 | Ethicon Endo-Surgery, Inc. | Flexible drive member |
US9289256B2 (en) | 2012-06-28 | 2016-03-22 | Ethicon Endo-Surgery, Llc | Surgical end effectors having angled tissue-contacting surfaces |
US20140001231A1 (en) | 2012-06-28 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Firing system lockout arrangements for surgical instruments |
US9282974B2 (en) | 2012-06-28 | 2016-03-15 | Ethicon Endo-Surgery, Llc | Empty clip cartridge lockout |
BR112014032776B1 (en) | 2012-06-28 | 2021-09-08 | Ethicon Endo-Surgery, Inc | SURGICAL INSTRUMENT SYSTEM AND SURGICAL KIT FOR USE WITH A SURGICAL INSTRUMENT SYSTEM |
US9101385B2 (en) | 2012-06-28 | 2015-08-11 | Ethicon Endo-Surgery, Inc. | Electrode connections for rotary driven surgical tools |
US20140005705A1 (en) | 2012-06-29 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Surgical instruments with articulating shafts |
US9028494B2 (en) | 2012-06-28 | 2015-05-12 | Ethicon Endo-Surgery, Inc. | Interchangeable end effector coupling arrangement |
US9561038B2 (en) | 2012-06-28 | 2017-02-07 | Ethicon Endo-Surgery, Llc | Interchangeable clip applier |
US9072524B2 (en) | 2012-06-29 | 2015-07-07 | Covidien Lp | Surgical forceps |
US9408622B2 (en) | 2012-06-29 | 2016-08-09 | Ethicon Endo-Surgery, Llc | Surgical instruments with articulating shafts |
US9326788B2 (en) | 2012-06-29 | 2016-05-03 | Ethicon Endo-Surgery, Llc | Lockout mechanism for use with robotic electrosurgical device |
US9039691B2 (en) | 2012-06-29 | 2015-05-26 | Covidien Lp | Surgical forceps |
US9393037B2 (en) | 2012-06-29 | 2016-07-19 | Ethicon Endo-Surgery, Llc | Surgical instruments with articulating shafts |
US9226767B2 (en) | 2012-06-29 | 2016-01-05 | Ethicon Endo-Surgery, Inc. | Closed feedback control for electrosurgical device |
US9351754B2 (en) | 2012-06-29 | 2016-05-31 | Ethicon Endo-Surgery, Llc | Ultrasonic surgical instruments with distally positioned jaw assemblies |
US9198714B2 (en) | 2012-06-29 | 2015-12-01 | Ethicon Endo-Surgery, Inc. | Haptic feedback devices for surgical robot |
US20140005702A1 (en) | 2012-06-29 | 2014-01-02 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments with distally positioned transducers |
US9820768B2 (en) | 2012-06-29 | 2017-11-21 | Ethicon Llc | Ultrasonic surgical instruments with control mechanisms |
US9833285B2 (en) | 2012-07-17 | 2017-12-05 | Covidien Lp | Optical sealing device with cutting ability |
US8939975B2 (en) | 2012-07-17 | 2015-01-27 | Covidien Lp | Gap control via overmold teeth and hard stops |
US10368945B2 (en) | 2012-07-17 | 2019-08-06 | Covidien Lp | Surgical instrument for energy-based tissue treatment |
US9301798B2 (en) | 2012-07-19 | 2016-04-05 | Covidien Lp | Surgical forceps including reposable end effector assemblies |
US9192421B2 (en) | 2012-07-24 | 2015-11-24 | Covidien Lp | Blade lockout mechanism for surgical forceps |
US9636168B2 (en) | 2012-08-09 | 2017-05-02 | Covidien Lp | Electrosurgical instrument including nested knife assembly |
US9433461B2 (en) | 2012-09-07 | 2016-09-06 | Covidien Lp | Instruments, systems, and methods for sealing tissue structures |
BR122020022677B1 (en) | 2012-09-26 | 2023-01-10 | Aesculap Ag | ELECTRO SURGICAL DEVICE FOR CUTTING AND SEALING TISSUES |
US9492224B2 (en) | 2012-09-28 | 2016-11-15 | EthiconEndo-Surgery, LLC | Multi-function bi-polar forceps |
US9439711B2 (en) | 2012-10-02 | 2016-09-13 | Covidien Lp | Medical devices for thermally treating tissue |
US9687290B2 (en) | 2012-10-02 | 2017-06-27 | Covidien Lp | Energy-based medical devices |
US9549749B2 (en) | 2012-10-08 | 2017-01-24 | Covidien Lp | Surgical forceps |
US9526564B2 (en) | 2012-10-08 | 2016-12-27 | Covidien Lp | Electric stapler device |
US9681908B2 (en) | 2012-10-08 | 2017-06-20 | Covidien Lp | Jaw assemblies for electrosurgical instruments and methods of manufacturing jaw assemblies |
US9265566B2 (en) | 2012-10-16 | 2016-02-23 | Covidien Lp | Surgical instrument |
US9095367B2 (en) | 2012-10-22 | 2015-08-04 | Ethicon Endo-Surgery, Inc. | Flexible harmonic waveguides/blades for surgical instruments |
US9375259B2 (en) | 2012-10-24 | 2016-06-28 | Covidien Lp | Electrosurgical instrument including an adhesive applicator assembly |
US10206583B2 (en) | 2012-10-31 | 2019-02-19 | Covidien Lp | Surgical devices and methods utilizing optical coherence tomography (OCT) to monitor and control tissue sealing |
US9572529B2 (en) | 2012-10-31 | 2017-02-21 | Covidien Lp | Surgical devices and methods utilizing optical coherence tomography (OCT) to monitor and control tissue sealing |
US20140135804A1 (en) | 2012-11-15 | 2014-05-15 | Ethicon Endo-Surgery, Inc. | Ultrasonic and electrosurgical devices |
US10772674B2 (en) | 2012-11-15 | 2020-09-15 | Covidien Lp | Deployment mechanisms for surgical instruments |
US9375205B2 (en) | 2012-11-15 | 2016-06-28 | Covidien Lp | Deployment mechanisms for surgical instruments |
US9498281B2 (en) | 2012-11-27 | 2016-11-22 | Covidien Lp | Surgical apparatus |
US9375256B2 (en) | 2013-02-05 | 2016-06-28 | Covidien Lp | Electrosurgical forceps |
US9386984B2 (en) | 2013-02-08 | 2016-07-12 | Ethicon Endo-Surgery, Llc | Staple cartridge comprising a releasable cover |
US10265119B2 (en) | 2013-02-15 | 2019-04-23 | Covidien Lp | Electrosurgical forceps |
US9713491B2 (en) | 2013-02-19 | 2017-07-25 | Covidien Lp | Method for manufacturing an electrode assembly configured for use with an electrosurigcal instrument |
US9375262B2 (en) | 2013-02-27 | 2016-06-28 | Covidien Lp | Limited use medical devices |
US10092292B2 (en) | 2013-02-28 | 2018-10-09 | Ethicon Llc | Staple forming features for surgical stapling instrument |
US20140249557A1 (en) | 2013-03-01 | 2014-09-04 | Ethicon Endo-Surgery, Inc. | Thumbwheel switch arrangements for surgical instruments |
RU2669463C2 (en) | 2013-03-01 | 2018-10-11 | Этикон Эндо-Серджери, Инк. | Surgical instrument with soft stop |
BR112015021098B1 (en) | 2013-03-01 | 2022-02-15 | Ethicon Endo-Surgery, Inc | COVERAGE FOR A JOINT JOINT AND SURGICAL INSTRUMENT |
US10070916B2 (en) | 2013-03-11 | 2018-09-11 | Covidien Lp | Surgical instrument with system and method for springing open jaw members |
US9456863B2 (en) | 2013-03-11 | 2016-10-04 | Covidien Lp | Surgical instrument with switch activation control |
US9655673B2 (en) | 2013-03-11 | 2017-05-23 | Covidien Lp | Surgical instrument |
US9877775B2 (en) | 2013-03-12 | 2018-01-30 | Covidien Lp | Electrosurgical instrument with a knife blade stop |
US9345481B2 (en) | 2013-03-13 | 2016-05-24 | Ethicon Endo-Surgery, Llc | Staple cartridge tissue thickness sensor system |
US9883860B2 (en) | 2013-03-14 | 2018-02-06 | Ethicon Llc | Interchangeable shaft assemblies for use with a surgical instrument |
US9629629B2 (en) | 2013-03-14 | 2017-04-25 | Ethicon Endo-Surgey, LLC | Control systems for surgical instruments |
US10226273B2 (en) | 2013-03-14 | 2019-03-12 | Ethicon Llc | Mechanical fasteners for use with surgical energy devices |
US9572577B2 (en) | 2013-03-27 | 2017-02-21 | Ethicon Endo-Surgery, Llc | Fastener cartridge comprising a tissue thickness compensator including openings therein |
US9795384B2 (en) | 2013-03-27 | 2017-10-24 | Ethicon Llc | Fastener cartridge comprising a tissue thickness compensator and a gap setting element |
US9332984B2 (en) | 2013-03-27 | 2016-05-10 | Ethicon Endo-Surgery, Llc | Fastener cartridge assemblies |
BR112015026109B1 (en) | 2013-04-16 | 2022-02-22 | Ethicon Endo-Surgery, Inc | surgical instrument |
US10136887B2 (en) | 2013-04-16 | 2018-11-27 | Ethicon Llc | Drive system decoupling arrangement for a surgical instrument |
USD728786S1 (en) | 2013-05-03 | 2015-05-05 | Covidien Lp | Vessel sealer with mechanical cutter and pistol-grip-style trigger |
US9468453B2 (en) | 2013-05-03 | 2016-10-18 | Covidien Lp | Endoscopic surgical forceps |
US9622810B2 (en) | 2013-05-10 | 2017-04-18 | Covidien Lp | Surgical forceps |
US9574644B2 (en) | 2013-05-30 | 2017-02-21 | Ethicon Endo-Surgery, Llc | Power module for use with a surgical instrument |
US9649151B2 (en) | 2013-05-31 | 2017-05-16 | Covidien Lp | End effector assemblies and methods of manufacturing end effector assemblies for treating and/or cutting tissue |
US10722292B2 (en) | 2013-05-31 | 2020-07-28 | Covidien Lp | Surgical device with an end-effector assembly and system for monitoring of tissue during a surgical procedure |
US9554845B2 (en) | 2013-07-18 | 2017-01-31 | Covidien Lp | Surgical forceps for treating and cutting tissue |
USD736920S1 (en) | 2013-08-07 | 2015-08-18 | Covidien Lp | Open vessel sealer with mechanical cutter |
US10966779B2 (en) | 2013-08-07 | 2021-04-06 | Covidien Lp | Bipolar surgical instrument |
US10499975B2 (en) | 2013-08-07 | 2019-12-10 | Covidien Lp | Bipolar surgical instrument |
WO2015017992A1 (en) | 2013-08-07 | 2015-02-12 | Covidien Lp | Surgical forceps |
USD726910S1 (en) | 2013-08-07 | 2015-04-14 | Covidien Lp | Reusable forceps for open vessel sealer with mechanical cutter |
US10751110B2 (en) | 2013-08-07 | 2020-08-25 | Covidien Lp | Bipolar surgical instrument with tissue stop |
USD744644S1 (en) | 2013-08-07 | 2015-12-01 | Covidien Lp | Disposable housing for open vessel sealer with mechanical cutter |
WO2015017991A1 (en) | 2013-08-07 | 2015-02-12 | Covidien Lp | Bipolar surgical instrument |
US10405874B2 (en) | 2013-08-13 | 2019-09-10 | Covidien Lp | Surgical instrument |
US9439717B2 (en) | 2013-08-13 | 2016-09-13 | Covidien Lp | Surgical forceps including thermal spread control |
MX369362B (en) | 2013-08-23 | 2019-11-06 | Ethicon Endo Surgery Llc | Firing member retraction devices for powered surgical instruments. |
US9924942B2 (en) | 2013-08-23 | 2018-03-27 | Ethicon Llc | Motor-powered articulatable surgical instruments |
US9295514B2 (en) | 2013-08-30 | 2016-03-29 | Ethicon Endo-Surgery, Llc | Surgical devices with close quarter articulation features |
US9814514B2 (en) | 2013-09-13 | 2017-11-14 | Ethicon Llc | Electrosurgical (RF) medical instruments for cutting and coagulating tissue |
US9445865B2 (en) | 2013-09-16 | 2016-09-20 | Covidien Lp | Electrosurgical instrument with end-effector assembly including electrically-conductive, tissue-engaging surfaces and switchable bipolar electrodes |
US9943357B2 (en) | 2013-09-16 | 2018-04-17 | Covidien Lp | Split electrode for use in a bipolar electrosurgical instrument |
US9861428B2 (en) | 2013-09-16 | 2018-01-09 | Ethicon Llc | Integrated systems for electrosurgical steam or smoke control |
US9717548B2 (en) | 2013-09-24 | 2017-08-01 | Covidien Lp | Electrode for use in a bipolar electrosurgical instrument |
US10610289B2 (en) | 2013-09-25 | 2020-04-07 | Covidien Lp | Devices, systems, and methods for grasping, treating, and dividing tissue |
US10231772B2 (en) | 2013-09-25 | 2019-03-19 | Covidien Lp | Wire retention unit for a surgical instrument |
US9642671B2 (en) | 2013-09-30 | 2017-05-09 | Covidien Lp | Limited-use medical device |
USD788302S1 (en) | 2013-10-01 | 2017-05-30 | Covidien Lp | Knife for endoscopic electrosurgical forceps |
US9265926B2 (en) | 2013-11-08 | 2016-02-23 | Ethicon Endo-Surgery, Llc | Electrosurgical devices |
US9526565B2 (en) | 2013-11-08 | 2016-12-27 | Ethicon Endo-Surgery, Llc | Electrosurgical devices |
US9974601B2 (en) | 2013-11-19 | 2018-05-22 | Covidien Lp | Vessel sealing instrument with suction system |
GB2521229A (en) | 2013-12-16 | 2015-06-17 | Ethicon Endo Surgery Inc | Medical device |
GB2521228A (en) | 2013-12-16 | 2015-06-17 | Ethicon Endo Surgery Inc | Medical device |
US20150173756A1 (en) | 2013-12-23 | 2015-06-25 | Ethicon Endo-Surgery, Inc. | Surgical cutting and stapling methods |
US9585662B2 (en) | 2013-12-23 | 2017-03-07 | Ethicon Endo-Surgery, Llc | Fastener cartridge comprising an extendable firing member |
US9839428B2 (en) | 2013-12-23 | 2017-12-12 | Ethicon Llc | Surgical cutting and stapling instruments with independent jaw control features |
US9724092B2 (en) | 2013-12-23 | 2017-08-08 | Ethicon Llc | Modular surgical instruments |
US9795436B2 (en) | 2014-01-07 | 2017-10-24 | Ethicon Llc | Harvesting energy from a surgical generator |
US9408660B2 (en) | 2014-01-17 | 2016-08-09 | Ethicon Endo-Surgery, Llc | Device trigger dampening mechanism |
US10231776B2 (en) | 2014-01-29 | 2019-03-19 | Covidien Lp | Tissue sealing instrument with tissue-dissecting electrode |
US10130413B2 (en) | 2014-02-11 | 2018-11-20 | Covidien Lp | Temperature-sensing electrically-conductive tissue-contacting plate and methods of manufacturing same |
US11090109B2 (en) | 2014-02-11 | 2021-08-17 | Covidien Lp | Temperature-sensing electrically-conductive tissue-contacting plate configured for use in an electrosurgical jaw member, electrosurgical system including same, and methods of controlling vessel sealing using same |
US9962161B2 (en) | 2014-02-12 | 2018-05-08 | Ethicon Llc | Deliverable surgical instrument |
CN106232029B (en) | 2014-02-24 | 2019-04-12 | 伊西康内外科有限责任公司 | Fastening system including firing member locking piece |
US20140166725A1 (en) | 2014-02-24 | 2014-06-19 | Ethicon Endo-Surgery, Inc. | Staple cartridge including a barbed staple. |
US9554854B2 (en) | 2014-03-18 | 2017-01-31 | Ethicon Endo-Surgery, Llc | Detecting short circuits in electrosurgical medical devices |
US9820738B2 (en) | 2014-03-26 | 2017-11-21 | Ethicon Llc | Surgical instrument comprising interactive systems |
US9913642B2 (en) | 2014-03-26 | 2018-03-13 | Ethicon Llc | Surgical instrument comprising a sensor system |
US9804618B2 (en) | 2014-03-26 | 2017-10-31 | Ethicon Llc | Systems and methods for controlling a segmented circuit |
BR112016021943B1 (en) | 2014-03-26 | 2022-06-14 | Ethicon Endo-Surgery, Llc | SURGICAL INSTRUMENT FOR USE BY AN OPERATOR IN A SURGICAL PROCEDURE |
US20150272580A1 (en) | 2014-03-26 | 2015-10-01 | Ethicon Endo-Surgery, Inc. | Verification of number of battery exchanges/procedure count |
US10463421B2 (en) | 2014-03-27 | 2019-11-05 | Ethicon Llc | Two stage trigger, clamp and cut bipolar vessel sealer |
US10092310B2 (en) | 2014-03-27 | 2018-10-09 | Ethicon Llc | Electrosurgical devices |
US10524852B1 (en) | 2014-03-28 | 2020-01-07 | Ethicon Llc | Distal sealing end effector with spacers |
US9737355B2 (en) | 2014-03-31 | 2017-08-22 | Ethicon Llc | Controlling impedance rise in electrosurgical medical devices |
US10278768B2 (en) | 2014-04-02 | 2019-05-07 | Covidien Lp | Electrosurgical devices including transverse electrode configurations |
US10342601B2 (en) | 2014-04-02 | 2019-07-09 | Covidien Lp | Electrosurgical devices including transverse electrode configurations |
US9913680B2 (en) | 2014-04-15 | 2018-03-13 | Ethicon Llc | Software algorithms for electrosurgical instruments |
US9801628B2 (en) | 2014-09-26 | 2017-10-31 | Ethicon Llc | Surgical staple and driver arrangements for staple cartridges |
CN106456176B (en) | 2014-04-16 | 2019-06-28 | 伊西康内外科有限责任公司 | Fastener cartridge including the extension with various configuration |
JP6532889B2 (en) | 2014-04-16 | 2019-06-19 | エシコン エルエルシーEthicon LLC | Fastener cartridge assembly and staple holder cover arrangement |
US20150297222A1 (en) | 2014-04-16 | 2015-10-22 | Ethicon Endo-Surgery, Inc. | Fastener cartridges including extensions having different configurations |
BR112016023825B1 (en) | 2014-04-16 | 2022-08-02 | Ethicon Endo-Surgery, Llc | STAPLE CARTRIDGE FOR USE WITH A SURGICAL STAPLER AND STAPLE CARTRIDGE FOR USE WITH A SURGICAL INSTRUMENT |
US11185330B2 (en) | 2014-04-16 | 2021-11-30 | Cilag Gmbh International | Fastener cartridge assemblies and staple retainer cover arrangements |
US9757186B2 (en) | 2014-04-17 | 2017-09-12 | Ethicon Llc | Device status feedback for bipolar tissue spacer |
US9687295B2 (en) | 2014-04-17 | 2017-06-27 | Covidien Lp | Methods of manufacturing a pair of jaw members of an end-effector assembly for a surgical instrument |
US9668733B2 (en) | 2014-04-21 | 2017-06-06 | Covidien Lp | Stapling device with features to prevent inadvertent firing of staples |
US10045781B2 (en) | 2014-06-13 | 2018-08-14 | Ethicon Llc | Closure lockout systems for surgical instruments |
US9700333B2 (en) | 2014-06-30 | 2017-07-11 | Ethicon Llc | Surgical instrument with variable tissue compression |
US10285724B2 (en) | 2014-07-31 | 2019-05-14 | Ethicon Llc | Actuation mechanisms and load adjustment assemblies for surgical instruments |
US9877776B2 (en) | 2014-08-25 | 2018-01-30 | Ethicon Llc | Simultaneous I-beam and spring driven cam jaw closure mechanism |
US10194976B2 (en) | 2014-08-25 | 2019-02-05 | Ethicon Llc | Lockout disabling mechanism |
US10231777B2 (en) | 2014-08-26 | 2019-03-19 | Covidien Lp | Methods of manufacturing jaw members of an end-effector assembly for a surgical instrument |
US10194972B2 (en) | 2014-08-26 | 2019-02-05 | Ethicon Llc | Managing tissue treatment |
US10660694B2 (en) | 2014-08-27 | 2020-05-26 | Covidien Lp | Vessel sealing instrument and switch assemblies thereof |
US10135242B2 (en) | 2014-09-05 | 2018-11-20 | Ethicon Llc | Smart cartridge wake up operation and data retention |
US11311294B2 (en) | 2014-09-05 | 2022-04-26 | Cilag Gmbh International | Powered medical device including measurement of closure state of jaws |
BR112017004361B1 (en) | 2014-09-05 | 2023-04-11 | Ethicon Llc | ELECTRONIC SYSTEM FOR A SURGICAL INSTRUMENT |
US10820939B2 (en) | 2014-09-15 | 2020-11-03 | Covidien Lp | Vessel-sealing device including force-balance interface and electrosurgical system including same |
US10080605B2 (en) | 2014-09-17 | 2018-09-25 | Covidien Lp | Deployment mechanisms for surgical instruments |
US10080606B2 (en) | 2014-09-17 | 2018-09-25 | Covidien Lp | Method of forming a member of an end effector |
US10039592B2 (en) | 2014-09-17 | 2018-08-07 | Covidien Lp | Deployment mechanisms for surgical instruments |
US10039593B2 (en) | 2014-09-17 | 2018-08-07 | Covidien Lp | Surgical instrument having a bipolar end effector assembly and a deployable monopolar assembly |
US9987076B2 (en) | 2014-09-17 | 2018-06-05 | Covidien Lp | Multi-function surgical instruments |
US9918785B2 (en) | 2014-09-17 | 2018-03-20 | Covidien Lp | Deployment mechanisms for surgical instruments |
US10105142B2 (en) | 2014-09-18 | 2018-10-23 | Ethicon Llc | Surgical stapler with plurality of cutting elements |
US11207127B2 (en) | 2014-09-25 | 2021-12-28 | Covidien Lp | Surgical instruments facilitating replacement of disposable components and/or sterilization of reusable components |
US10258360B2 (en) | 2014-09-25 | 2019-04-16 | Covidien Lp | Surgical instruments |
CN106999202B (en) | 2014-09-25 | 2019-11-15 | 柯惠有限合伙公司 | The surgical instruments of extensible length |
MX2017003960A (en) | 2014-09-26 | 2017-12-04 | Ethicon Llc | Surgical stapling buttresses and adjunct materials. |
US11523821B2 (en) | 2014-09-26 | 2022-12-13 | Cilag Gmbh International | Method for creating a flexible staple line |
US10076325B2 (en) | 2014-10-13 | 2018-09-18 | Ethicon Llc | Surgical stapling apparatus comprising a tissue stop |
US9924944B2 (en) | 2014-10-16 | 2018-03-27 | Ethicon Llc | Staple cartridge comprising an adjunct material |
US11141153B2 (en) | 2014-10-29 | 2021-10-12 | Cilag Gmbh International | Staple cartridges comprising driver arrangements |
US10517594B2 (en) | 2014-10-29 | 2019-12-31 | Ethicon Llc | Cartridge assemblies for surgical staplers |
US9844376B2 (en) | 2014-11-06 | 2017-12-19 | Ethicon Llc | Staple cartridge comprising a releasable adjunct material |
US10639092B2 (en) | 2014-12-08 | 2020-05-05 | Ethicon Llc | Electrode configurations for surgical instruments |
US10736636B2 (en) | 2014-12-10 | 2020-08-11 | Ethicon Llc | Articulatable surgical instrument system |
US10188385B2 (en) | 2014-12-18 | 2019-01-29 | Ethicon Llc | Surgical instrument system comprising lockable systems |
RU2703684C2 (en) | 2014-12-18 | 2019-10-21 | ЭТИКОН ЭНДО-СЕРДЖЕРИ, ЭлЭлСи | Surgical instrument with anvil which is selectively movable relative to staple cartridge around discrete fixed axis |
US10463422B2 (en) | 2014-12-18 | 2019-11-05 | Covidien Lp | Surgical instrument with stopper assembly |
US9844375B2 (en) | 2014-12-18 | 2017-12-19 | Ethicon Llc | Drive arrangements for articulatable surgical instruments |
US10117649B2 (en) | 2014-12-18 | 2018-11-06 | Ethicon Llc | Surgical instrument assembly comprising a lockable articulation system |
US10004501B2 (en) | 2014-12-18 | 2018-06-26 | Ethicon Llc | Surgical instruments with improved closure arrangements |
US9844374B2 (en) | 2014-12-18 | 2017-12-19 | Ethicon Llc | Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member |
US9987000B2 (en) | 2014-12-18 | 2018-06-05 | Ethicon Llc | Surgical instrument assembly comprising a flexible articulation system |
US10085748B2 (en) | 2014-12-18 | 2018-10-02 | Ethicon Llc | Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors |
US10092348B2 (en) | 2014-12-22 | 2018-10-09 | Ethicon Llc | RF tissue sealer, shear grip, trigger lock mechanism and energy activation |
US10159524B2 (en) | 2014-12-22 | 2018-12-25 | Ethicon Llc | High power battery powered RF amplifier topology |
US10111699B2 (en) | 2014-12-22 | 2018-10-30 | Ethicon Llc | RF tissue sealer, shear grip, trigger lock mechanism and energy activation |
USD748259S1 (en) | 2014-12-29 | 2016-01-26 | Applied Medical Resources Corporation | Electrosurgical instrument |
US10172612B2 (en) | 2015-01-21 | 2019-01-08 | Covidien Lp | Surgical instruments with force applier and methods of use |
US10245095B2 (en) | 2015-02-06 | 2019-04-02 | Ethicon Llc | Electrosurgical instrument with rotation and articulation mechanisms |
US11154301B2 (en) | 2015-02-27 | 2021-10-26 | Cilag Gmbh International | Modular stapling assembly |
US10321907B2 (en) | 2015-02-27 | 2019-06-18 | Ethicon Llc | System for monitoring whether a surgical instrument needs to be serviced |
US10180463B2 (en) | 2015-02-27 | 2019-01-15 | Ethicon Llc | Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band |
US10226250B2 (en) | 2015-02-27 | 2019-03-12 | Ethicon Llc | Modular stapling assembly |
US9993248B2 (en) | 2015-03-06 | 2018-06-12 | Ethicon Endo-Surgery, Llc | Smart sensors with local signal processing |
US10617412B2 (en) | 2015-03-06 | 2020-04-14 | Ethicon Llc | System for detecting the mis-insertion of a staple cartridge into a surgical stapler |
US10045776B2 (en) | 2015-03-06 | 2018-08-14 | Ethicon Llc | Control techniques and sub-processor contained within modular shaft with select control processing from handle |
US9901342B2 (en) | 2015-03-06 | 2018-02-27 | Ethicon Endo-Surgery, Llc | Signal and power communication system positioned on a rotatable shaft |
US9924961B2 (en) | 2015-03-06 | 2018-03-27 | Ethicon Endo-Surgery, Llc | Interactive feedback system for powered surgical instruments |
US10052044B2 (en) | 2015-03-06 | 2018-08-21 | Ethicon Llc | Time dependent evaluation of sensor data to determine stability, creep, and viscoelastic elements of measures |
US10687806B2 (en) | 2015-03-06 | 2020-06-23 | Ethicon Llc | Adaptive tissue compression techniques to adjust closure rates for multiple tissue types |
JP2020121162A (en) | 2015-03-06 | 2020-08-13 | エシコン エルエルシーEthicon LLC | Time dependent evaluation of sensor data to determine stability element, creep element and viscoelastic element of measurement |
US10245033B2 (en) | 2015-03-06 | 2019-04-02 | Ethicon Llc | Surgical instrument comprising a lockable battery housing |
US9895148B2 (en) | 2015-03-06 | 2018-02-20 | Ethicon Endo-Surgery, Llc | Monitoring speed control and precision incrementing of motor for powered surgical instruments |
US9808246B2 (en) | 2015-03-06 | 2017-11-07 | Ethicon Endo-Surgery, Llc | Method of operating a powered surgical instrument |
US10441279B2 (en) | 2015-03-06 | 2019-10-15 | Ethicon Llc | Multiple level thresholds to modify operation of powered surgical instruments |
US10653476B2 (en) | 2015-03-12 | 2020-05-19 | Covidien Lp | Mapping vessels for resecting body tissue |
US10206736B2 (en) | 2015-03-13 | 2019-02-19 | Covidien Lp | Surgical forceps with scalpel functionality |
US10321950B2 (en) | 2015-03-17 | 2019-06-18 | Ethicon Llc | Managing tissue treatment |
US10342602B2 (en) | 2015-03-17 | 2019-07-09 | Ethicon Llc | Managing tissue treatment |
US10595929B2 (en) | 2015-03-24 | 2020-03-24 | Ethicon Llc | Surgical instruments with firing system overload protection mechanisms |
US10390825B2 (en) | 2015-03-31 | 2019-08-27 | Ethicon Llc | Surgical instrument with progressive rotary drive systems |
US10314638B2 (en) | 2015-04-07 | 2019-06-11 | Ethicon Llc | Articulating radio frequency (RF) tissue seal with articulating state sensing |
US10117702B2 (en) | 2015-04-10 | 2018-11-06 | Ethicon Llc | Surgical generator systems and related methods |
US10130410B2 (en) | 2015-04-17 | 2018-11-20 | Ethicon Llc | Electrosurgical instrument including a cutting member decouplable from a cutting member trigger |
US10383628B2 (en) * | 2015-04-20 | 2019-08-20 | Medi Tulip Co., Ltd | Surgical linear stapler |
WO2016169037A1 (en) | 2015-04-24 | 2016-10-27 | Covidien Lp | Vessel sealing device with fine dissection function |
US10595933B2 (en) | 2015-04-24 | 2020-03-24 | Covidien Lp | Multifunctional vessel sealing and divider device |
US9872725B2 (en) | 2015-04-29 | 2018-01-23 | Ethicon Llc | RF tissue sealer with mode selection |
US9974602B2 (en) | 2015-05-27 | 2018-05-22 | Covidien Lp | Surgical instruments and devices and methods facilitating the manufacture of the same |
US10226269B2 (en) | 2015-05-27 | 2019-03-12 | Covidien Lp | Surgical forceps |
US10441340B2 (en) | 2015-05-27 | 2019-10-15 | Covidien Lp | Surgical forceps |
US9956022B2 (en) | 2015-05-27 | 2018-05-01 | Covidien Lp | Surgical forceps and methods of manufacturing the same |
US9848935B2 (en) * | 2015-05-27 | 2017-12-26 | Covidien Lp | Surgical instruments including components and features facilitating the assembly and manufacturing thereof |
US10722293B2 (en) | 2015-05-29 | 2020-07-28 | Covidien Lp | Surgical device with an end effector assembly and system for monitoring of tissue before and after a surgical procedure |
US11020140B2 (en) | 2015-06-17 | 2021-06-01 | Cilag Gmbh International | Ultrasonic surgical blade for use with ultrasonic surgical instruments |
US10405863B2 (en) | 2015-06-18 | 2019-09-10 | Ethicon Llc | Movable firing beam support arrangements for articulatable surgical instruments |
US10357303B2 (en) | 2015-06-30 | 2019-07-23 | Ethicon Llc | Translatable outer tube for sealing using shielded lap chole dissector |
US11141213B2 (en) | 2015-06-30 | 2021-10-12 | Cilag Gmbh International | Surgical instrument with user adaptable techniques |
US10034704B2 (en) | 2015-06-30 | 2018-07-31 | Ethicon Llc | Surgical instrument with user adaptable algorithms |
US11129669B2 (en) | 2015-06-30 | 2021-09-28 | Cilag Gmbh International | Surgical system with user adaptable techniques based on tissue type |
US10898256B2 (en) | 2015-06-30 | 2021-01-26 | Ethicon Llc | Surgical system with user adaptable techniques based on tissue impedance |
US11051873B2 (en) | 2015-06-30 | 2021-07-06 | Cilag Gmbh International | Surgical system with user adaptable techniques employing multiple energy modalities based on tissue parameters |
US10154852B2 (en) | 2015-07-01 | 2018-12-18 | Ethicon Llc | Ultrasonic surgical blade with improved cutting and coagulation features |
USD844138S1 (en) | 2015-07-17 | 2019-03-26 | Covidien Lp | Handle assembly of a multi-function surgical instrument |
USD844139S1 (en) | 2015-07-17 | 2019-03-26 | Covidien Lp | Monopolar assembly of a multi-function surgical instrument |
US9987078B2 (en) | 2015-07-22 | 2018-06-05 | Covidien Lp | Surgical forceps |
US10631918B2 (en) | 2015-08-14 | 2020-04-28 | Covidien Lp | Energizable surgical attachment for a mechanical clamp |
US11058425B2 (en) | 2015-08-17 | 2021-07-13 | Ethicon Llc | Implantable layers for a surgical instrument |
BR112018003693B1 (en) | 2015-08-26 | 2022-11-22 | Ethicon Llc | SURGICAL STAPLE CARTRIDGE FOR USE WITH A SURGICAL STAPPING INSTRUMENT |
US10098642B2 (en) | 2015-08-26 | 2018-10-16 | Ethicon Llc | Surgical staples comprising features for improved fastening of tissue |
US10238390B2 (en) | 2015-09-02 | 2019-03-26 | Ethicon Llc | Surgical staple cartridges with driver arrangements for establishing herringbone staple patterns |
MX2022006189A (en) | 2015-09-02 | 2022-06-16 | Ethicon Llc | Surgical staple configurations with camming surfaces located between portions supporting surgical staples. |
US10076326B2 (en) | 2015-09-23 | 2018-09-18 | Ethicon Llc | Surgical stapler having current mirror-based motor control |
US10105139B2 (en) | 2015-09-23 | 2018-10-23 | Ethicon Llc | Surgical stapler having downstream current-based motor control |
US10085751B2 (en) | 2015-09-23 | 2018-10-02 | Ethicon Llc | Surgical stapler having temperature-based motor control |
US10327769B2 (en) | 2015-09-23 | 2019-06-25 | Ethicon Llc | Surgical stapler having motor control based on a drive system component |
US10238386B2 (en) | 2015-09-23 | 2019-03-26 | Ethicon Llc | Surgical stapler having motor control based on an electrical parameter related to a motor current |
US10363036B2 (en) | 2015-09-23 | 2019-07-30 | Ethicon Llc | Surgical stapler having force-based motor control |
US10299878B2 (en) | 2015-09-25 | 2019-05-28 | Ethicon Llc | Implantable adjunct systems for determining adjunct skew |
US10561420B2 (en) | 2015-09-30 | 2020-02-18 | Ethicon Llc | Tubular absorbable constructs |
US10285699B2 (en) | 2015-09-30 | 2019-05-14 | Ethicon Llc | Compressible adjunct |
US11890015B2 (en) | 2015-09-30 | 2024-02-06 | Cilag Gmbh International | Compressible adjunct with crossing spacer fibers |
US10687884B2 (en) | 2015-09-30 | 2020-06-23 | Ethicon Llc | Circuits for supplying isolated direct current (DC) voltage to surgical instruments |
US10980539B2 (en) | 2015-09-30 | 2021-04-20 | Ethicon Llc | Implantable adjunct comprising bonded layers |
US10959771B2 (en) | 2015-10-16 | 2021-03-30 | Ethicon Llc | Suction and irrigation sealing grasper |
US10595930B2 (en) | 2015-10-16 | 2020-03-24 | Ethicon Llc | Electrode wiping surgical device |
US10213221B2 (en) | 2015-10-28 | 2019-02-26 | Covidien Lp | Surgical instruments including cam surfaces |
US10154877B2 (en) | 2015-11-04 | 2018-12-18 | Covidien Lp | Endoscopic surgical instrument |
US10213250B2 (en) | 2015-11-05 | 2019-02-26 | Covidien Lp | Deployment and safety mechanisms for surgical instruments |
WO2017085847A1 (en) * | 2015-11-19 | 2017-05-26 | オリンパス株式会社 | Energy treatment tool and energy treatment system |
US10111660B2 (en) | 2015-12-03 | 2018-10-30 | Covidien Lp | Surgical stapler flexible distal tip |
US10368865B2 (en) | 2015-12-30 | 2019-08-06 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10292704B2 (en) | 2015-12-30 | 2019-05-21 | Ethicon Llc | Mechanisms for compensating for battery pack failure in powered surgical instruments |
US10959806B2 (en) | 2015-12-30 | 2021-03-30 | Ethicon Llc | Energized medical device with reusable handle |
US10179022B2 (en) | 2015-12-30 | 2019-01-15 | Ethicon Llc | Jaw position impedance limiter for electrosurgical instrument |
US10265068B2 (en) | 2015-12-30 | 2019-04-23 | Ethicon Llc | Surgical instruments with separable motors and motor control circuits |
US10575892B2 (en) | 2015-12-31 | 2020-03-03 | Ethicon Llc | Adapter for electrical surgical instruments |
US10172672B2 (en) | 2016-01-11 | 2019-01-08 | Covidien Lp | Jaw force control for electrosurgical forceps |
US11129670B2 (en) | 2016-01-15 | 2021-09-28 | Cilag Gmbh International | Modular battery powered handheld surgical instrument with selective application of energy based on button displacement, intensity, or local tissue characterization |
US10709469B2 (en) | 2016-01-15 | 2020-07-14 | Ethicon Llc | Modular battery powered handheld surgical instrument with energy conservation techniques |
US11229471B2 (en) | 2016-01-15 | 2022-01-25 | Cilag Gmbh International | Modular battery powered handheld surgical instrument with selective application of energy based on tissue characterization |
US10716615B2 (en) | 2016-01-15 | 2020-07-21 | Ethicon Llc | Modular battery powered handheld surgical instrument with curved end effectors having asymmetric engagement between jaw and blade |
US10426543B2 (en) | 2016-01-23 | 2019-10-01 | Covidien Lp | Knife trigger for vessel sealer |
US10695123B2 (en) | 2016-01-29 | 2020-06-30 | Covidien Lp | Surgical instrument with sensor |
WO2017132970A1 (en) | 2016-02-05 | 2017-08-10 | Covidien Lp | Articulation assemblies for use with endoscopic surgical instruments |
BR112018016098B1 (en) | 2016-02-09 | 2023-02-23 | Ethicon Llc | SURGICAL INSTRUMENT |
US10433837B2 (en) | 2016-02-09 | 2019-10-08 | Ethicon Llc | Surgical instruments with multiple link articulation arrangements |
US11213293B2 (en) | 2016-02-09 | 2022-01-04 | Cilag Gmbh International | Articulatable surgical instruments with single articulation link arrangements |
US11224426B2 (en) | 2016-02-12 | 2022-01-18 | Cilag Gmbh International | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10448948B2 (en) | 2016-02-12 | 2019-10-22 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10258331B2 (en) | 2016-02-12 | 2019-04-16 | Ethicon Llc | Mechanisms for compensating for drivetrain failure in powered surgical instruments |
US10555769B2 (en) | 2016-02-22 | 2020-02-11 | Ethicon Llc | Flexible circuits for electrosurgical instrument |
US10537381B2 (en) | 2016-02-26 | 2020-01-21 | Covidien Lp | Surgical instrument having a bipolar end effector assembly and a deployable monopolar assembly |
USD819815S1 (en) | 2016-03-09 | 2018-06-05 | Covidien Lp | L-shaped blade trigger for an electrosurgical instrument |
USD828554S1 (en) | 2016-03-09 | 2018-09-11 | Covidien Lp | Contoured blade trigger for an electrosurgical instrument |
US10485542B2 (en) | 2016-04-01 | 2019-11-26 | Ethicon Llc | Surgical stapling instrument comprising multiple lockouts |
US11284890B2 (en) | 2016-04-01 | 2022-03-29 | Cilag Gmbh International | Circular stapling system comprising an incisable tissue support |
US11045191B2 (en) | 2016-04-01 | 2021-06-29 | Cilag Gmbh International | Method for operating a surgical stapling system |
US10413293B2 (en) | 2016-04-01 | 2019-09-17 | Ethicon Llc | Interchangeable surgical tool assembly with a surgical end effector that is selectively rotatable about a shaft axis |
US10617413B2 (en) | 2016-04-01 | 2020-04-14 | Ethicon Llc | Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts |
US10335145B2 (en) | 2016-04-15 | 2019-07-02 | Ethicon Llc | Modular surgical instrument with configurable operating mode |
US10426467B2 (en) | 2016-04-15 | 2019-10-01 | Ethicon Llc | Surgical instrument with detection sensors |
US11607239B2 (en) | 2016-04-15 | 2023-03-21 | Cilag Gmbh International | Systems and methods for controlling a surgical stapling and cutting instrument |
US11179150B2 (en) | 2016-04-15 | 2021-11-23 | Cilag Gmbh International | Systems and methods for controlling a surgical stapling and cutting instrument |
US10405859B2 (en) | 2016-04-15 | 2019-09-10 | Ethicon Llc | Surgical instrument with adjustable stop/start control during a firing motion |
US10456137B2 (en) | 2016-04-15 | 2019-10-29 | Ethicon Llc | Staple formation detection mechanisms |
US10828028B2 (en) | 2016-04-15 | 2020-11-10 | Ethicon Llc | Surgical instrument with multiple program responses during a firing motion |
US10492783B2 (en) | 2016-04-15 | 2019-12-03 | Ethicon, Llc | Surgical instrument with improved stop/start control during a firing motion |
US10357247B2 (en) | 2016-04-15 | 2019-07-23 | Ethicon Llc | Surgical instrument with multiple program responses during a firing motion |
US20170296173A1 (en) | 2016-04-18 | 2017-10-19 | Ethicon Endo-Surgery, Llc | Method for operating a surgical instrument |
US11317917B2 (en) | 2016-04-18 | 2022-05-03 | Cilag Gmbh International | Surgical stapling system comprising a lockable firing assembly |
US10478181B2 (en) | 2016-04-18 | 2019-11-19 | Ethicon Llc | Cartridge lockout arrangements for rotary powered surgical cutting and stapling instruments |
US10646269B2 (en) | 2016-04-29 | 2020-05-12 | Ethicon Llc | Non-linear jaw gap for electrosurgical instruments |
US10485607B2 (en) | 2016-04-29 | 2019-11-26 | Ethicon Llc | Jaw structure with distal closure for electrosurgical instruments |
US10856934B2 (en) | 2016-04-29 | 2020-12-08 | Ethicon Llc | Electrosurgical instrument with electrically conductive gap setting and tissue engaging members |
US10702329B2 (en) | 2016-04-29 | 2020-07-07 | Ethicon Llc | Jaw structure with distal post for electrosurgical instruments |
US10987156B2 (en) | 2016-04-29 | 2021-04-27 | Ethicon Llc | Electrosurgical instrument with electrically conductive gap setting member and electrically insulative tissue engaging members |
US10456193B2 (en) | 2016-05-03 | 2019-10-29 | Ethicon Llc | Medical device with a bilateral jaw configuration for nerve stimulation |
CN109310431B (en) | 2016-06-24 | 2022-03-04 | 伊西康有限责任公司 | Staple cartridge comprising wire staples and punch staples |
USD826405S1 (en) | 2016-06-24 | 2018-08-21 | Ethicon Llc | Surgical fastener |
USD850617S1 (en) | 2016-06-24 | 2019-06-04 | Ethicon Llc | Surgical fastener cartridge |
US10675024B2 (en) | 2016-06-24 | 2020-06-09 | Ethicon Llc | Staple cartridge comprising overdriven staples |
USD847989S1 (en) | 2016-06-24 | 2019-05-07 | Ethicon Llc | Surgical fastener cartridge |
US10245064B2 (en) | 2016-07-12 | 2019-04-02 | Ethicon Llc | Ultrasonic surgical instrument with piezoelectric central lumen transducer |
US10893883B2 (en) | 2016-07-13 | 2021-01-19 | Ethicon Llc | Ultrasonic assembly for use with ultrasonic surgical instruments |
US10517665B2 (en) | 2016-07-14 | 2019-12-31 | Covidien Lp | Devices and methods for tissue sealing and mechanical clipping |
US10842522B2 (en) | 2016-07-15 | 2020-11-24 | Ethicon Llc | Ultrasonic surgical instruments having offset blades |
US10856933B2 (en) | 2016-08-02 | 2020-12-08 | Covidien Lp | Surgical instrument housing incorporating a channel and methods of manufacturing the same |
US10376305B2 (en) | 2016-08-05 | 2019-08-13 | Ethicon Llc | Methods and systems for advanced harmonic energy |
US10285723B2 (en) | 2016-08-09 | 2019-05-14 | Ethicon Llc | Ultrasonic surgical blade with improved heel portion |
US10631887B2 (en) | 2016-08-15 | 2020-04-28 | Covidien Lp | Electrosurgical forceps for video assisted thoracoscopic surgery and other surgical procedures |
USD847990S1 (en) | 2016-08-16 | 2019-05-07 | Ethicon Llc | Surgical instrument |
US10441305B2 (en) | 2016-08-18 | 2019-10-15 | Covidien Lp | Surgical forceps |
US10772642B2 (en) | 2016-08-18 | 2020-09-15 | Covidien Lp | Surgical forceps |
US10952759B2 (en) | 2016-08-25 | 2021-03-23 | Ethicon Llc | Tissue loading of a surgical instrument |
US10779847B2 (en) | 2016-08-25 | 2020-09-22 | Ethicon Llc | Ultrasonic transducer to waveguide joining |
US10751117B2 (en) | 2016-09-23 | 2020-08-25 | Ethicon Llc | Electrosurgical instrument with fluid diverter |
US11207091B2 (en) | 2016-11-08 | 2021-12-28 | Covidien Lp | Surgical instrument for grasping, treating, and/or dividing tissue |
US10918407B2 (en) | 2016-11-08 | 2021-02-16 | Covidien Lp | Surgical instrument for grasping, treating, and/or dividing tissue |
US10603064B2 (en) | 2016-11-28 | 2020-03-31 | Ethicon Llc | Ultrasonic transducer |
US11266430B2 (en) | 2016-11-29 | 2022-03-08 | Cilag Gmbh International | End effector control and calibration |
US10993715B2 (en) | 2016-12-21 | 2021-05-04 | Ethicon Llc | Staple cartridge comprising staples with different clamping breadths |
JP7010956B2 (en) | 2016-12-21 | 2022-01-26 | エシコン エルエルシー | How to staple tissue |
US10682138B2 (en) | 2016-12-21 | 2020-06-16 | Ethicon Llc | Bilaterally asymmetric staple forming pocket pairs |
US10856868B2 (en) | 2016-12-21 | 2020-12-08 | Ethicon Llc | Firing member pin configurations |
US10675025B2 (en) | 2016-12-21 | 2020-06-09 | Ethicon Llc | Shaft assembly comprising separately actuatable and retractable systems |
US10687810B2 (en) | 2016-12-21 | 2020-06-23 | Ethicon Llc | Stepped staple cartridge with tissue retention and gap setting features |
US10588632B2 (en) | 2016-12-21 | 2020-03-17 | Ethicon Llc | Surgical end effectors and firing members thereof |
US11419606B2 (en) | 2016-12-21 | 2022-08-23 | Cilag Gmbh International | Shaft assembly comprising a clutch configured to adapt the output of a rotary firing member to two different systems |
US11134942B2 (en) | 2016-12-21 | 2021-10-05 | Cilag Gmbh International | Surgical stapling instruments and staple-forming anvils |
US10758229B2 (en) | 2016-12-21 | 2020-09-01 | Ethicon Llc | Surgical instrument comprising improved jaw control |
US20180168625A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical stapling instruments with smart staple cartridges |
BR112019011947A2 (en) | 2016-12-21 | 2019-10-29 | Ethicon Llc | surgical stapling systems |
US20180168615A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Method of deforming staples from two different types of staple cartridges with the same surgical stapling instrument |
US10588630B2 (en) | 2016-12-21 | 2020-03-17 | Ethicon Llc | Surgical tool assemblies with closure stroke reduction features |
US10945727B2 (en) | 2016-12-21 | 2021-03-16 | Ethicon Llc | Staple cartridge with deformable driver retention features |
US20180168608A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Surgical instrument system comprising an end effector lockout and a firing assembly lockout |
US11684367B2 (en) | 2016-12-21 | 2023-06-27 | Cilag Gmbh International | Stepped assembly having and end-of-life indicator |
US10675026B2 (en) | 2016-12-21 | 2020-06-09 | Ethicon Llc | Methods of stapling tissue |
US20180168648A1 (en) | 2016-12-21 | 2018-06-21 | Ethicon Endo-Surgery, Llc | Durability features for end effectors and firing assemblies of surgical stapling instruments |
US10517595B2 (en) | 2016-12-21 | 2019-12-31 | Ethicon Llc | Jaw actuated lock arrangements for preventing advancement of a firing member in a surgical end effector unless an unfired cartridge is installed in the end effector |
US10426471B2 (en) | 2016-12-21 | 2019-10-01 | Ethicon Llc | Surgical instrument with multiple failure response modes |
US10893864B2 (en) | 2016-12-21 | 2021-01-19 | Ethicon | Staple cartridges and arrangements of staples and staple cavities therein |
CN110099619B (en) | 2016-12-21 | 2022-07-15 | 爱惜康有限责任公司 | Lockout device for surgical end effector and replaceable tool assembly |
US10617414B2 (en) | 2016-12-21 | 2020-04-14 | Ethicon Llc | Closure member arrangements for surgical instruments |
US10813695B2 (en) | 2017-01-27 | 2020-10-27 | Covidien Lp | Reflectors for optical-based vessel sealing |
US11229480B2 (en) | 2017-02-02 | 2022-01-25 | Covidien Lp | Latching mechanism for in-line activated electrosurgical device |
US10881445B2 (en) | 2017-02-09 | 2021-01-05 | Covidien Lp | Adapters, systems incorporating the same, and methods for providing an electrosurgical forceps with clip-applying functionality |
US11033325B2 (en) | 2017-02-16 | 2021-06-15 | Cilag Gmbh International | Electrosurgical instrument with telescoping suction port and debris cleaner |
EP3595561B1 (en) | 2017-03-13 | 2021-12-01 | Covidien LP | Electrosurgical instrument with trigger driven cutting function |
US10799284B2 (en) | 2017-03-15 | 2020-10-13 | Ethicon Llc | Electrosurgical instrument with textured jaws |
US11497546B2 (en) | 2017-03-31 | 2022-11-15 | Cilag Gmbh International | Area ratios of patterned coatings on RF electrodes to reduce sticking |
US11172980B2 (en) | 2017-05-12 | 2021-11-16 | Covidien Lp | Electrosurgical forceps for grasping, treating, and/or dividing tissue |
US10973567B2 (en) | 2017-05-12 | 2021-04-13 | Covidien Lp | Electrosurgical forceps for grasping, treating, and/or dividing tissue |
US11166759B2 (en) | 2017-05-16 | 2021-11-09 | Covidien Lp | Surgical forceps |
USD843574S1 (en) | 2017-06-08 | 2019-03-19 | Covidien Lp | Knife for open vessel sealer |
USD854149S1 (en) | 2017-06-08 | 2019-07-16 | Covidien Lp | End effector for open vessel sealer |
US10512501B2 (en) | 2017-06-08 | 2019-12-24 | Covidien Lp | Electrosurgical apparatus |
USD854684S1 (en) | 2017-06-08 | 2019-07-23 | Covidien Lp | Open vessel sealer with mechanical cutter |
USD859658S1 (en) | 2017-06-16 | 2019-09-10 | Covidien Lp | Vessel sealer for tonsillectomy |
US10368864B2 (en) | 2017-06-20 | 2019-08-06 | Ethicon Llc | Systems and methods for controlling displaying motor velocity for a surgical instrument |
USD890784S1 (en) | 2017-06-20 | 2020-07-21 | Ethicon Llc | Display panel with changeable graphical user interface |
US11071554B2 (en) | 2017-06-20 | 2021-07-27 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements |
USD879808S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with graphical user interface |
US10888321B2 (en) | 2017-06-20 | 2021-01-12 | Ethicon Llc | Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument |
USD879809S1 (en) | 2017-06-20 | 2020-03-31 | Ethicon Llc | Display panel with changeable graphical user interface |
US10779820B2 (en) | 2017-06-20 | 2020-09-22 | Ethicon Llc | Systems and methods for controlling motor speed according to user input for a surgical instrument |
US10881399B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument |
US10646220B2 (en) | 2017-06-20 | 2020-05-12 | Ethicon Llc | Systems and methods for controlling displacement member velocity for a surgical instrument |
US10881396B2 (en) | 2017-06-20 | 2021-01-05 | Ethicon Llc | Surgical instrument with variable duration trigger arrangement |
US10390841B2 (en) | 2017-06-20 | 2019-08-27 | Ethicon Llc | Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation |
US10307170B2 (en) | 2017-06-20 | 2019-06-04 | Ethicon Llc | Method for closed loop control of motor velocity of a surgical stapling and cutting instrument |
US10624633B2 (en) | 2017-06-20 | 2020-04-21 | Ethicon Llc | Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument |
US11653914B2 (en) | 2017-06-20 | 2023-05-23 | Cilag Gmbh International | Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector |
US11090046B2 (en) | 2017-06-20 | 2021-08-17 | Cilag Gmbh International | Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument |
US10980537B2 (en) | 2017-06-20 | 2021-04-20 | Ethicon Llc | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations |
US11382638B2 (en) | 2017-06-20 | 2022-07-12 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified displacement distance |
US11517325B2 (en) | 2017-06-20 | 2022-12-06 | Cilag Gmbh International | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured displacement distance traveled over a specified time interval |
US10813639B2 (en) | 2017-06-20 | 2020-10-27 | Ethicon Llc | Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions |
US10327767B2 (en) | 2017-06-20 | 2019-06-25 | Ethicon Llc | Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation |
US10772629B2 (en) | 2017-06-27 | 2020-09-15 | Ethicon Llc | Surgical anvil arrangements |
US11266405B2 (en) | 2017-06-27 | 2022-03-08 | Cilag Gmbh International | Surgical anvil manufacturing methods |
US11324503B2 (en) | 2017-06-27 | 2022-05-10 | Cilag Gmbh International | Surgical firing member arrangements |
US10993716B2 (en) | 2017-06-27 | 2021-05-04 | Ethicon Llc | Surgical anvil arrangements |
US10856869B2 (en) | 2017-06-27 | 2020-12-08 | Ethicon Llc | Surgical anvil arrangements |
US20180368844A1 (en) | 2017-06-27 | 2018-12-27 | Ethicon Llc | Staple forming pocket arrangements |
US11246592B2 (en) | 2017-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical instrument comprising an articulation system lockable to a frame |
USD869655S1 (en) | 2017-06-28 | 2019-12-10 | Ethicon Llc | Surgical fastener cartridge |
USD851762S1 (en) | 2017-06-28 | 2019-06-18 | Ethicon Llc | Anvil |
USD854151S1 (en) | 2017-06-28 | 2019-07-16 | Ethicon Llc | Surgical instrument shaft |
US11678880B2 (en) | 2017-06-28 | 2023-06-20 | Cilag Gmbh International | Surgical instrument comprising a shaft including a housing arrangement |
US10903685B2 (en) | 2017-06-28 | 2021-01-26 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies forming capacitive channels |
US10211586B2 (en) | 2017-06-28 | 2019-02-19 | Ethicon Llc | Surgical shaft assemblies with watertight housings |
US11259805B2 (en) | 2017-06-28 | 2022-03-01 | Cilag Gmbh International | Surgical instrument comprising firing member supports |
USD906355S1 (en) | 2017-06-28 | 2020-12-29 | Ethicon Llc | Display screen or portion thereof with a graphical user interface for a surgical instrument |
US10716614B2 (en) | 2017-06-28 | 2020-07-21 | Ethicon Llc | Surgical shaft assemblies with slip ring assemblies with increased contact pressure |
US11020114B2 (en) | 2017-06-28 | 2021-06-01 | Cilag Gmbh International | Surgical instruments with articulatable end effector with axially shortened articulation joint configurations |
EP3420947B1 (en) | 2017-06-28 | 2022-05-25 | Cilag GmbH International | Surgical instrument comprising selectively actuatable rotatable couplers |
US10765427B2 (en) | 2017-06-28 | 2020-09-08 | Ethicon Llc | Method for articulating a surgical instrument |
US11564686B2 (en) | 2017-06-28 | 2023-01-31 | Cilag Gmbh International | Surgical shaft assemblies with flexible interfaces |
US10603117B2 (en) | 2017-06-28 | 2020-03-31 | Ethicon Llc | Articulation state detection mechanisms |
US10932772B2 (en) | 2017-06-29 | 2021-03-02 | Ethicon Llc | Methods for closed loop velocity control for robotic surgical instrument |
US10258418B2 (en) | 2017-06-29 | 2019-04-16 | Ethicon Llc | System for controlling articulation forces |
US11007022B2 (en) | 2017-06-29 | 2021-05-18 | Ethicon Llc | Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument |
US10398434B2 (en) | 2017-06-29 | 2019-09-03 | Ethicon Llc | Closed loop velocity control of closure member for robotic surgical instrument |
US10898183B2 (en) | 2017-06-29 | 2021-01-26 | Ethicon Llc | Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing |
US10820920B2 (en) | 2017-07-05 | 2020-11-03 | Ethicon Llc | Reusable ultrasonic medical devices and methods of their use |
US11944300B2 (en) | 2017-08-03 | 2024-04-02 | Cilag Gmbh International | Method for operating a surgical system bailout |
US11471155B2 (en) | 2017-08-03 | 2022-10-18 | Cilag Gmbh International | Surgical system bailout |
US11304695B2 (en) | 2017-08-03 | 2022-04-19 | Cilag Gmbh International | Surgical system shaft interconnection |
US11154348B2 (en) | 2017-08-29 | 2021-10-26 | Covidien Lp | Surgical instruments and methods of assembling surgical instruments |
US10729501B2 (en) | 2017-09-29 | 2020-08-04 | Ethicon Llc | Systems and methods for language selection of a surgical instrument |
US10796471B2 (en) | 2017-09-29 | 2020-10-06 | Ethicon Llc | Systems and methods of displaying a knife position for a surgical instrument |
USD907647S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
US11484358B2 (en) | 2017-09-29 | 2022-11-01 | Cilag Gmbh International | Flexible electrosurgical instrument |
USD917500S1 (en) | 2017-09-29 | 2021-04-27 | Ethicon Llc | Display screen or portion thereof with graphical user interface |
US10743872B2 (en) | 2017-09-29 | 2020-08-18 | Ethicon Llc | System and methods for controlling a display of a surgical instrument |
US10765429B2 (en) | 2017-09-29 | 2020-09-08 | Ethicon Llc | Systems and methods for providing alerts according to the operational state of a surgical instrument |
US11033323B2 (en) | 2017-09-29 | 2021-06-15 | Cilag Gmbh International | Systems and methods for managing fluid and suction in electrosurgical systems |
US11399829B2 (en) | 2017-09-29 | 2022-08-02 | Cilag Gmbh International | Systems and methods of initiating a power shutdown mode for a surgical instrument |
USD907648S1 (en) | 2017-09-29 | 2021-01-12 | Ethicon Llc | Display screen or portion thereof with animated graphical user interface |
US11490951B2 (en) | 2017-09-29 | 2022-11-08 | Cilag Gmbh International | Saline contact with electrodes |
US11134944B2 (en) | 2017-10-30 | 2021-10-05 | Cilag Gmbh International | Surgical stapler knife motion controls |
US11090075B2 (en) | 2017-10-30 | 2021-08-17 | Cilag Gmbh International | Articulation features for surgical end effector |
US11207066B2 (en) | 2017-10-30 | 2021-12-28 | Covidien Lp | Apparatus for endoscopic procedures |
US10987104B2 (en) | 2017-10-30 | 2021-04-27 | Covidien Lp | Apparatus for endoscopic procedures |
US10779903B2 (en) | 2017-10-31 | 2020-09-22 | Ethicon Llc | Positive shaft rotation lock activated by jaw closure |
US10842490B2 (en) | 2017-10-31 | 2020-11-24 | Ethicon Llc | Cartridge body design with force reduction based on firing completion |
US10743875B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member |
US10687813B2 (en) | 2017-12-15 | 2020-06-23 | Ethicon Llc | Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments |
US11006955B2 (en) | 2017-12-15 | 2021-05-18 | Ethicon Llc | End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments |
US11033267B2 (en) | 2017-12-15 | 2021-06-15 | Ethicon Llc | Systems and methods of controlling a clamping member firing rate of a surgical instrument |
US10743874B2 (en) | 2017-12-15 | 2020-08-18 | Ethicon Llc | Sealed adapters for use with electromechanical surgical instruments |
US10779825B2 (en) | 2017-12-15 | 2020-09-22 | Ethicon Llc | Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments |
US10966718B2 (en) | 2017-12-15 | 2021-04-06 | Ethicon Llc | Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments |
US11197670B2 (en) | 2017-12-15 | 2021-12-14 | Cilag Gmbh International | Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed |
US10869666B2 (en) | 2017-12-15 | 2020-12-22 | Ethicon Llc | Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument |
US11071543B2 (en) | 2017-12-15 | 2021-07-27 | Cilag Gmbh International | Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges |
US10779826B2 (en) | 2017-12-15 | 2020-09-22 | Ethicon Llc | Methods of operating surgical end effectors |
US10828033B2 (en) | 2017-12-15 | 2020-11-10 | Ethicon Llc | Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto |
USD910847S1 (en) | 2017-12-19 | 2021-02-16 | Ethicon Llc | Surgical instrument assembly |
US11045270B2 (en) | 2017-12-19 | 2021-06-29 | Cilag Gmbh International | Robotic attachment comprising exterior drive actuator |
US10716565B2 (en) | 2017-12-19 | 2020-07-21 | Ethicon Llc | Surgical instruments with dual articulation drivers |
US10729509B2 (en) | 2017-12-19 | 2020-08-04 | Ethicon Llc | Surgical instrument comprising closure and firing locking mechanism |
US10835330B2 (en) | 2017-12-19 | 2020-11-17 | Ethicon Llc | Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly |
US11020112B2 (en) | 2017-12-19 | 2021-06-01 | Ethicon Llc | Surgical tools configured for interchangeable use with different controller interfaces |
US11179151B2 (en) | 2017-12-21 | 2021-11-23 | Cilag Gmbh International | Surgical instrument comprising a display |
US11129680B2 (en) | 2017-12-21 | 2021-09-28 | Cilag Gmbh International | Surgical instrument comprising a projector |
US11076853B2 (en) | 2017-12-21 | 2021-08-03 | Cilag Gmbh International | Systems and methods of displaying a knife position during transection for a surgical instrument |
US11311290B2 (en) | 2017-12-21 | 2022-04-26 | Cilag Gmbh International | Surgical instrument comprising an end effector dampener |
US11123132B2 (en) | 2018-04-09 | 2021-09-21 | Covidien Lp | Multi-function surgical instruments and assemblies therefor |
US10828756B2 (en) | 2018-04-24 | 2020-11-10 | Covidien Lp | Disassembly methods facilitating reprocessing of multi-function surgical instruments |
US10780544B2 (en) | 2018-04-24 | 2020-09-22 | Covidien Lp | Systems and methods facilitating reprocessing of surgical instruments |
US11033289B2 (en) | 2018-05-02 | 2021-06-15 | Covidien Lp | Jaw guard for surgical forceps |
US11109930B2 (en) | 2018-06-08 | 2021-09-07 | Covidien Lp | Enhanced haptic feedback system |
US11896291B2 (en) | 2018-07-02 | 2024-02-13 | Covidien Lp | Electrically-insulative shafts, methods of manufacturing electrically-insulative shafts, and energy-based surgical instruments incorporating electrically-insulative shafts |
US11497490B2 (en) | 2018-07-09 | 2022-11-15 | Covidien Lp | Powered surgical devices including predictive motor control |
USD914878S1 (en) | 2018-08-20 | 2021-03-30 | Ethicon Llc | Surgical instrument anvil |
US11253256B2 (en) | 2018-08-20 | 2022-02-22 | Cilag Gmbh International | Articulatable motor powered surgical instruments with dedicated articulation motor arrangements |
US11045192B2 (en) | 2018-08-20 | 2021-06-29 | Cilag Gmbh International | Fabricating techniques for surgical stapler anvils |
US11207065B2 (en) | 2018-08-20 | 2021-12-28 | Cilag Gmbh International | Method for fabricating surgical stapler anvils |
US11324501B2 (en) | 2018-08-20 | 2022-05-10 | Cilag Gmbh International | Surgical stapling devices with improved closure members |
US10856870B2 (en) | 2018-08-20 | 2020-12-08 | Ethicon Llc | Switching arrangements for motor powered articulatable surgical instruments |
US10779821B2 (en) | 2018-08-20 | 2020-09-22 | Ethicon Llc | Surgical stapler anvils with tissue stop features configured to avoid tissue pinch |
US10842492B2 (en) | 2018-08-20 | 2020-11-24 | Ethicon Llc | Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system |
US11039834B2 (en) | 2018-08-20 | 2021-06-22 | Cilag Gmbh International | Surgical stapler anvils with staple directing protrusions and tissue stability features |
US11083458B2 (en) | 2018-08-20 | 2021-08-10 | Cilag Gmbh International | Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions |
US10912559B2 (en) | 2018-08-20 | 2021-02-09 | Ethicon Llc | Reinforced deformable anvil tip for surgical stapler anvil |
US11291440B2 (en) | 2018-08-20 | 2022-04-05 | Cilag Gmbh International | Method for operating a powered articulatable surgical instrument |
US11612403B2 (en) | 2018-10-03 | 2023-03-28 | Covidien Lp | Multi-function surgical transection instrument |
US11376062B2 (en) | 2018-10-12 | 2022-07-05 | Covidien Lp | Electrosurgical forceps |
US11471211B2 (en) | 2018-10-12 | 2022-10-18 | Covidien Lp | Electrosurgical forceps |
US10881452B2 (en) | 2018-10-16 | 2021-01-05 | Covidien Lp | Method of assembling an end effector for a surgical instrument |
US11197734B2 (en) | 2018-10-30 | 2021-12-14 | Covidien Lp | Load sensing devices for use in surgical instruments |
US11369372B2 (en) | 2018-11-28 | 2022-06-28 | Covidien Lp | Surgical stapler adapter with flexible cable assembly, flexible fingers, and contact clips |
US11350982B2 (en) | 2018-12-05 | 2022-06-07 | Covidien Lp | Electrosurgical forceps |
US11246648B2 (en) | 2018-12-10 | 2022-02-15 | Covidien Lp | Surgical forceps with bilateral and unilateral jaw members |
US11202635B2 (en) | 2019-02-04 | 2021-12-21 | Covidien Lp | Programmable distal tilt position of end effector for powered surgical devices |
US11376006B2 (en) | 2019-02-06 | 2022-07-05 | Covidien Lp | End effector force measurement with digital drive circuit |
US11219461B2 (en) | 2019-03-08 | 2022-01-11 | Covidien Lp | Strain gauge stabilization in a surgical device |
US11147613B2 (en) | 2019-03-15 | 2021-10-19 | Covidien Lp | Surgical instrument with increased lever stroke |
US11523861B2 (en) | 2019-03-22 | 2022-12-13 | Covidien Lp | Methods for manufacturing a jaw assembly for an electrosurgical forceps |
US11696761B2 (en) | 2019-03-25 | 2023-07-11 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
US11147553B2 (en) | 2019-03-25 | 2021-10-19 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
US11147551B2 (en) | 2019-03-25 | 2021-10-19 | Cilag Gmbh International | Firing drive arrangements for surgical systems |
US11172929B2 (en) | 2019-03-25 | 2021-11-16 | Cilag Gmbh International | Articulation drive arrangements for surgical systems |
US11576696B2 (en) | 2019-03-29 | 2023-02-14 | Covidien Lp | Engagement features and methods for attaching a drive rod to a knife blade in an articulating surgical instrument |
US11490916B2 (en) | 2019-03-29 | 2022-11-08 | Covidien Lp | Engagement features and methods for attaching a drive rod to a knife blade in an articulating surgical instrument |
US11490917B2 (en) | 2019-03-29 | 2022-11-08 | Covidien Lp | Drive rod and knife blade for an articulating surgical instrument |
US11452528B2 (en) | 2019-04-30 | 2022-09-27 | Cilag Gmbh International | Articulation actuators for a surgical instrument |
US11471157B2 (en) | 2019-04-30 | 2022-10-18 | Cilag Gmbh International | Articulation control mapping for a surgical instrument |
US11432816B2 (en) | 2019-04-30 | 2022-09-06 | Cilag Gmbh International | Articulation pin for a surgical instrument |
US11253254B2 (en) | 2019-04-30 | 2022-02-22 | Cilag Gmbh International | Shaft rotation actuator on a surgical instrument |
US11426251B2 (en) | 2019-04-30 | 2022-08-30 | Cilag Gmbh International | Articulation directional lights on a surgical instrument |
US11648009B2 (en) | 2019-04-30 | 2023-05-16 | Cilag Gmbh International | Rotatable jaw tip for a surgical instrument |
US11903581B2 (en) | 2019-04-30 | 2024-02-20 | Cilag Gmbh International | Methods for stapling tissue using a surgical instrument |
US11607267B2 (en) | 2019-06-10 | 2023-03-21 | Covidien Lp | Electrosurgical forceps |
US11413102B2 (en) | 2019-06-27 | 2022-08-16 | Cilag Gmbh International | Multi-access port for surgical robotic systems |
US11547468B2 (en) | 2019-06-27 | 2023-01-10 | Cilag Gmbh International | Robotic surgical system with safety and cooperative sensing control |
US11723729B2 (en) | 2019-06-27 | 2023-08-15 | Cilag Gmbh International | Robotic surgical assembly coupling safety mechanisms |
US11612445B2 (en) | 2019-06-27 | 2023-03-28 | Cilag Gmbh International | Cooperative operation of robotic arms |
US11607278B2 (en) | 2019-06-27 | 2023-03-21 | Cilag Gmbh International | Cooperative robotic surgical systems |
US11426167B2 (en) | 2019-06-28 | 2022-08-30 | Cilag Gmbh International | Mechanisms for proper anvil attachment surgical stapling head assembly |
US11684434B2 (en) | 2019-06-28 | 2023-06-27 | Cilag Gmbh International | Surgical RFID assemblies for instrument operational setting control |
US11553971B2 (en) | 2019-06-28 | 2023-01-17 | Cilag Gmbh International | Surgical RFID assemblies for display and communication |
US11478241B2 (en) | 2019-06-28 | 2022-10-25 | Cilag Gmbh International | Staple cartridge including projections |
US11497492B2 (en) | 2019-06-28 | 2022-11-15 | Cilag Gmbh International | Surgical instrument including an articulation lock |
US11224497B2 (en) | 2019-06-28 | 2022-01-18 | Cilag Gmbh International | Surgical systems with multiple RFID tags |
US11229437B2 (en) | 2019-06-28 | 2022-01-25 | Cilag Gmbh International | Method for authenticating the compatibility of a staple cartridge with a surgical instrument |
US11399837B2 (en) | 2019-06-28 | 2022-08-02 | Cilag Gmbh International | Mechanisms for motor control adjustments of a motorized surgical instrument |
US11627959B2 (en) | 2019-06-28 | 2023-04-18 | Cilag Gmbh International | Surgical instruments including manual and powered system lockouts |
US11246678B2 (en) | 2019-06-28 | 2022-02-15 | Cilag Gmbh International | Surgical stapling system having a frangible RFID tag |
US11051807B2 (en) | 2019-06-28 | 2021-07-06 | Cilag Gmbh International | Packaging assembly including a particulate trap |
US11464601B2 (en) | 2019-06-28 | 2022-10-11 | Cilag Gmbh International | Surgical instrument comprising an RFID system for tracking a movable component |
US11771419B2 (en) | 2019-06-28 | 2023-10-03 | Cilag Gmbh International | Packaging for a replaceable component of a surgical stapling system |
US11259803B2 (en) | 2019-06-28 | 2022-03-01 | Cilag Gmbh International | Surgical stapling system having an information encryption protocol |
US11376098B2 (en) | 2019-06-28 | 2022-07-05 | Cilag Gmbh International | Surgical instrument system comprising an RFID system |
US11660163B2 (en) | 2019-06-28 | 2023-05-30 | Cilag Gmbh International | Surgical system with RFID tags for updating motor assembly parameters |
US11298132B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Inlernational | Staple cartridge including a honeycomb extension |
US11291451B2 (en) | 2019-06-28 | 2022-04-05 | Cilag Gmbh International | Surgical instrument with battery compatibility verification functionality |
US11298127B2 (en) | 2019-06-28 | 2022-04-12 | Cilag GmbH Interational | Surgical stapling system having a lockout mechanism for an incompatible cartridge |
US11638587B2 (en) | 2019-06-28 | 2023-05-02 | Cilag Gmbh International | RFID identification systems for surgical instruments |
US11219455B2 (en) | 2019-06-28 | 2022-01-11 | Cilag Gmbh International | Surgical instrument including a lockout key |
US11576672B2 (en) | 2019-12-19 | 2023-02-14 | Cilag Gmbh International | Surgical instrument comprising a closure system including a closure member and an opening member driven by a drive screw |
US11701111B2 (en) | 2019-12-19 | 2023-07-18 | Cilag Gmbh International | Method for operating a surgical stapling instrument |
US11844520B2 (en) | 2019-12-19 | 2023-12-19 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
US11234698B2 (en) | 2019-12-19 | 2022-02-01 | Cilag Gmbh International | Stapling system comprising a clamp lockout and a firing lockout |
US11607219B2 (en) | 2019-12-19 | 2023-03-21 | Cilag Gmbh International | Staple cartridge comprising a detachable tissue cutting knife |
US11931033B2 (en) | 2019-12-19 | 2024-03-19 | Cilag Gmbh International | Staple cartridge comprising a latch lockout |
US11504122B2 (en) | 2019-12-19 | 2022-11-22 | Cilag Gmbh International | Surgical instrument comprising a nested firing member |
US11464512B2 (en) | 2019-12-19 | 2022-10-11 | Cilag Gmbh International | Staple cartridge comprising a curved deck surface |
US11559304B2 (en) | 2019-12-19 | 2023-01-24 | Cilag Gmbh International | Surgical instrument comprising a rapid closure mechanism |
US11291447B2 (en) | 2019-12-19 | 2022-04-05 | Cilag Gmbh International | Stapling instrument comprising independent jaw closing and staple firing systems |
US11446029B2 (en) | 2019-12-19 | 2022-09-20 | Cilag Gmbh International | Staple cartridge comprising projections extending from a curved deck surface |
US11304696B2 (en) | 2019-12-19 | 2022-04-19 | Cilag Gmbh International | Surgical instrument comprising a powered articulation system |
US11529137B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Staple cartridge comprising driver retention members |
US11911032B2 (en) | 2019-12-19 | 2024-02-27 | Cilag Gmbh International | Staple cartridge comprising a seating cam |
US11529139B2 (en) | 2019-12-19 | 2022-12-20 | Cilag Gmbh International | Motor driven surgical instrument |
US11589916B2 (en) | 2019-12-30 | 2023-02-28 | Cilag Gmbh International | Electrosurgical instruments with electrodes having variable energy densities |
US11944366B2 (en) | 2019-12-30 | 2024-04-02 | Cilag Gmbh International | Asymmetric segmented ultrasonic support pad for cooperative engagement with a movable RF electrode |
US11452525B2 (en) | 2019-12-30 | 2022-09-27 | Cilag Gmbh International | Surgical instrument comprising an adjustment system |
US11779387B2 (en) | 2019-12-30 | 2023-10-10 | Cilag Gmbh International | Clamp arm jaw to minimize tissue sticking and improve tissue control |
US11786291B2 (en) | 2019-12-30 | 2023-10-17 | Cilag Gmbh International | Deflectable support of RF energy electrode with respect to opposing ultrasonic blade |
US11812957B2 (en) | 2019-12-30 | 2023-11-14 | Cilag Gmbh International | Surgical instrument comprising a signal interference resolution system |
US20210196344A1 (en) | 2019-12-30 | 2021-07-01 | Ethicon Llc | Surgical system communication pathways |
US11696776B2 (en) | 2019-12-30 | 2023-07-11 | Cilag Gmbh International | Articulatable surgical instrument |
US11779329B2 (en) | 2019-12-30 | 2023-10-10 | Cilag Gmbh International | Surgical instrument comprising a flex circuit including a sensor system |
US11911063B2 (en) | 2019-12-30 | 2024-02-27 | Cilag Gmbh International | Techniques for detecting ultrasonic blade to electrode contact and reducing power to ultrasonic blade |
US11744636B2 (en) | 2019-12-30 | 2023-09-05 | Cilag Gmbh International | Electrosurgical systems with integrated and external power sources |
US11937866B2 (en) | 2019-12-30 | 2024-03-26 | Cilag Gmbh International | Method for an electrosurgical procedure |
US11684412B2 (en) | 2019-12-30 | 2023-06-27 | Cilag Gmbh International | Surgical instrument with rotatable and articulatable surgical end effector |
US11660089B2 (en) | 2019-12-30 | 2023-05-30 | Cilag Gmbh International | Surgical instrument comprising a sensing system |
US11937863B2 (en) | 2019-12-30 | 2024-03-26 | Cilag Gmbh International | Deflectable electrode with variable compression bias along the length of the deflectable electrode |
US11458244B2 (en) | 2020-02-07 | 2022-10-04 | Covidien Lp | Irrigating surgical apparatus with positive pressure fluid |
US11376030B2 (en) | 2020-02-10 | 2022-07-05 | Covidien Lp | Devices and methods facilitating the manufacture of surgical instruments |
US11553913B2 (en) | 2020-02-11 | 2023-01-17 | Covidien Lp | Electrically-determining tissue cut with surgical stapling apparatus |
US11622804B2 (en) | 2020-03-16 | 2023-04-11 | Covidien Lp | Forceps with linear trigger mechanism |
US11844562B2 (en) | 2020-03-23 | 2023-12-19 | Covidien Lp | Electrosurgical forceps for grasping, treating, and/or dividing tissue |
USD974560S1 (en) | 2020-06-02 | 2023-01-03 | Cilag Gmbh International | Staple cartridge |
USD976401S1 (en) | 2020-06-02 | 2023-01-24 | Cilag Gmbh International | Staple cartridge |
USD966512S1 (en) | 2020-06-02 | 2022-10-11 | Cilag Gmbh International | Staple cartridge |
USD975278S1 (en) | 2020-06-02 | 2023-01-10 | Cilag Gmbh International | Staple cartridge |
USD975851S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
USD975850S1 (en) | 2020-06-02 | 2023-01-17 | Cilag Gmbh International | Staple cartridge |
USD967421S1 (en) | 2020-06-02 | 2022-10-18 | Cilag Gmbh International | Staple cartridge |
US11622768B2 (en) | 2020-07-13 | 2023-04-11 | Covidien Lp | Methods and structure for confirming proper assembly of powered surgical stapling systems |
US20220031350A1 (en) | 2020-07-28 | 2022-02-03 | Cilag Gmbh International | Surgical instruments with double pivot articulation joint arrangements |
US11660109B2 (en) | 2020-09-08 | 2023-05-30 | Covidien Lp | Cutting elements for surgical instruments such as for use in robotic surgical systems |
US11925406B2 (en) | 2020-09-14 | 2024-03-12 | Covidien Lp | End effector assemblies for surgical instruments |
US11534259B2 (en) | 2020-10-29 | 2022-12-27 | Cilag Gmbh International | Surgical instrument comprising an articulation indicator |
US11517390B2 (en) | 2020-10-29 | 2022-12-06 | Cilag Gmbh International | Surgical instrument comprising a limited travel switch |
US11452526B2 (en) | 2020-10-29 | 2022-09-27 | Cilag Gmbh International | Surgical instrument comprising a staged voltage regulation start-up system |
USD980425S1 (en) | 2020-10-29 | 2023-03-07 | Cilag Gmbh International | Surgical instrument assembly |
US11779330B2 (en) | 2020-10-29 | 2023-10-10 | Cilag Gmbh International | Surgical instrument comprising a jaw alignment system |
US11617577B2 (en) | 2020-10-29 | 2023-04-04 | Cilag Gmbh International | Surgical instrument comprising a sensor configured to sense whether an articulation drive of the surgical instrument is actuatable |
US11844518B2 (en) | 2020-10-29 | 2023-12-19 | Cilag Gmbh International | Method for operating a surgical instrument |
USD1013170S1 (en) | 2020-10-29 | 2024-01-30 | Cilag Gmbh International | Surgical instrument assembly |
US11896217B2 (en) | 2020-10-29 | 2024-02-13 | Cilag Gmbh International | Surgical instrument comprising an articulation lock |
US11717289B2 (en) | 2020-10-29 | 2023-08-08 | Cilag Gmbh International | Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable |
US11931025B2 (en) | 2020-10-29 | 2024-03-19 | Cilag Gmbh International | Surgical instrument comprising a releasable closure drive lock |
US11744580B2 (en) | 2020-11-24 | 2023-09-05 | Covidien Lp | Long stapler reloads with continuous cartridge |
US11653919B2 (en) | 2020-11-24 | 2023-05-23 | Covidien Lp | Stapler line reinforcement continuity |
US11653915B2 (en) | 2020-12-02 | 2023-05-23 | Cilag Gmbh International | Surgical instruments with sled location detection and adjustment features |
US11944296B2 (en) | 2020-12-02 | 2024-04-02 | Cilag Gmbh International | Powered surgical instruments with external connectors |
US11653920B2 (en) | 2020-12-02 | 2023-05-23 | Cilag Gmbh International | Powered surgical instruments with communication interfaces through sterile barrier |
US11744581B2 (en) | 2020-12-02 | 2023-09-05 | Cilag Gmbh International | Powered surgical instruments with multi-phase tissue treatment |
US11737751B2 (en) | 2020-12-02 | 2023-08-29 | Cilag Gmbh International | Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings |
US11678882B2 (en) | 2020-12-02 | 2023-06-20 | Cilag Gmbh International | Surgical instruments with interactive features to remedy incidental sled movements |
US11627960B2 (en) | 2020-12-02 | 2023-04-18 | Cilag Gmbh International | Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections |
US11890010B2 (en) | 2020-12-02 | 2024-02-06 | Cllag GmbH International | Dual-sided reinforced reload for surgical instruments |
US11849943B2 (en) | 2020-12-02 | 2023-12-26 | Cilag Gmbh International | Surgical instrument with cartridge release mechanisms |
US11806068B2 (en) | 2020-12-15 | 2023-11-07 | Covidien Lp | Energy-based surgical instrument for grasping, treating, and/or dividing tissue |
US11793514B2 (en) | 2021-02-26 | 2023-10-24 | Cilag Gmbh International | Staple cartridge comprising sensor array which may be embedded in cartridge body |
US11696757B2 (en) | 2021-02-26 | 2023-07-11 | Cilag Gmbh International | Monitoring of internal systems to detect and track cartridge motion status |
US11701113B2 (en) | 2021-02-26 | 2023-07-18 | Cilag Gmbh International | Stapling instrument comprising a separate power antenna and a data transfer antenna |
US11749877B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Stapling instrument comprising a signal antenna |
US11744583B2 (en) | 2021-02-26 | 2023-09-05 | Cilag Gmbh International | Distal communication array to tune frequency of RF systems |
US11925349B2 (en) | 2021-02-26 | 2024-03-12 | Cilag Gmbh International | Adjustment to transfer parameters to improve available power |
US11723657B2 (en) | 2021-02-26 | 2023-08-15 | Cilag Gmbh International | Adjustable communication based on available bandwidth and power capacity |
US11730473B2 (en) | 2021-02-26 | 2023-08-22 | Cilag Gmbh International | Monitoring of manufacturing life-cycle |
US11751869B2 (en) | 2021-02-26 | 2023-09-12 | Cilag Gmbh International | Monitoring of multiple sensors over time to detect moving characteristics of tissue |
US11812964B2 (en) | 2021-02-26 | 2023-11-14 | Cilag Gmbh International | Staple cartridge comprising a power management circuit |
US11717291B2 (en) | 2021-03-22 | 2023-08-08 | Cilag Gmbh International | Staple cartridge comprising staples configured to apply different tissue compression |
US11723658B2 (en) | 2021-03-22 | 2023-08-15 | Cilag Gmbh International | Staple cartridge comprising a firing lockout |
US11737749B2 (en) | 2021-03-22 | 2023-08-29 | Cilag Gmbh International | Surgical stapling instrument comprising a retraction system |
US11826012B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising a pulsed motor-driven firing rack |
US11826042B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Surgical instrument comprising a firing drive including a selectable leverage mechanism |
US11759202B2 (en) | 2021-03-22 | 2023-09-19 | Cilag Gmbh International | Staple cartridge comprising an implantable layer |
US11806011B2 (en) | 2021-03-22 | 2023-11-07 | Cilag Gmbh International | Stapling instrument comprising tissue compression systems |
US11744603B2 (en) | 2021-03-24 | 2023-09-05 | Cilag Gmbh International | Multi-axis pivot joints for surgical instruments and methods for manufacturing same |
US11849945B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Rotary-driven surgical stapling assembly comprising eccentrically driven firing member |
US11786239B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Surgical instrument articulation joint arrangements comprising multiple moving linkage features |
US11896219B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Mating features between drivers and underside of a cartridge deck |
US11793516B2 (en) | 2021-03-24 | 2023-10-24 | Cilag Gmbh International | Surgical staple cartridge comprising longitudinal support beam |
US11903582B2 (en) | 2021-03-24 | 2024-02-20 | Cilag Gmbh International | Leveraging surfaces for cartridge installation |
US11857183B2 (en) | 2021-03-24 | 2024-01-02 | Cilag Gmbh International | Stapling assembly components having metal substrates and plastic bodies |
US11786243B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Firing members having flexible portions for adapting to a load during a surgical firing stroke |
US11849944B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Drivers for fastener cartridge assemblies having rotary drive screws |
US11944336B2 (en) | 2021-03-24 | 2024-04-02 | Cilag Gmbh International | Joint arrangements for multi-planar alignment and support of operational drive shafts in articulatable surgical instruments |
US11832816B2 (en) | 2021-03-24 | 2023-12-05 | Cilag Gmbh International | Surgical stapling assembly comprising nonplanar staples and planar staples |
US11896218B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Method of using a powered stapling device |
US20220378426A1 (en) | 2021-05-28 | 2022-12-01 | Cilag Gmbh International | Stapling instrument comprising a mounted shaft orientation sensor |
US11684362B2 (en) | 2021-06-07 | 2023-06-27 | Covidien Lp | Handheld electromechanical surgical system |
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Citations (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3898992A (en) * | 1967-10-27 | 1975-08-12 | Ultrasonic Systems | Ultrasonic surgical methods |
US4608981A (en) | 1984-10-19 | 1986-09-02 | Senmed, Inc. | Surgical stapling instrument with staple height adjusting mechanism |
US4633874A (en) | 1984-10-19 | 1987-01-06 | Senmed, Inc. | Surgical stapling instrument with jaw latching mechanism and disposable staple cartridge |
US5104025A (en) | 1990-09-28 | 1992-04-14 | Ethicon, Inc. | Intraluminal anastomotic surgical stapler with detached anvil |
US5389098A (en) * | 1992-05-19 | 1995-02-14 | Olympus Optical Co., Ltd. | Surgical device for stapling and/or fastening body tissues |
US5403312A (en) | 1993-07-22 | 1995-04-04 | Ethicon, Inc. | Electrosurgical hemostatic device |
EP0717960A2 (en) * | 1994-12-22 | 1996-06-26 | Ethicon Endo-Surgery | Electrosurgical hemostatic device |
EP0737446A1 (en) * | 1995-04-12 | 1996-10-16 | Ethicon Endo-Surgery, Inc. | Electrosurgical hemostatic device with recessed and deformable electrodes |
US5597107A (en) | 1994-02-03 | 1997-01-28 | Ethicon Endo-Surgery, Inc. | Surgical stapler instrument |
Family Cites Families (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE3490633T (en) * | 1984-01-30 | 1985-12-12 | Char'kovskaja oblastnaja kliničeskaja bol'nica, Char'kov | Bipolar electrosurgical device |
US4655216A (en) * | 1985-07-23 | 1987-04-07 | Alfred Tischer | Combination instrument for laparoscopical tube sterilization |
FR2647683B1 (en) * | 1989-05-31 | 1993-02-12 | Kyocera Corp | BLOOD WATERPROOFING / COAGULATION DEVICE OUTSIDE BLOOD VESSELS |
DE4130064A1 (en) * | 1991-09-11 | 1993-03-18 | Wolf Gmbh Richard | ENDOSCOPIC COAGULATION GRIPPER |
US5383880A (en) * | 1992-01-17 | 1995-01-24 | Ethicon, Inc. | Endoscopic surgical system with sensing means |
GR940100335A (en) * | 1993-07-22 | 1996-05-22 | Ethicon Inc. | Electrosurgical device for placing staples. |
US5810811A (en) * | 1993-07-22 | 1998-09-22 | Ethicon Endo-Surgery, Inc. | Electrosurgical hemostatic device |
US5465895A (en) * | 1994-02-03 | 1995-11-14 | Ethicon Endo-Surgery, Inc. | Surgical stapler instrument |
-
1997
- 1997-05-14 US US08/856,520 patent/USH1904H/en not_active Abandoned
-
1998
- 1998-05-11 AU AU64870/98A patent/AU6487098A/en not_active Abandoned
- 1998-05-12 CA CA002237429A patent/CA2237429A1/en not_active Abandoned
- 1998-05-13 JP JP10148369A patent/JPH1170123A/en active Pending
- 1998-05-13 EP EP98303753A patent/EP0878168A1/en not_active Withdrawn
Patent Citations (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3898992A (en) * | 1967-10-27 | 1975-08-12 | Ultrasonic Systems | Ultrasonic surgical methods |
US4608981A (en) | 1984-10-19 | 1986-09-02 | Senmed, Inc. | Surgical stapling instrument with staple height adjusting mechanism |
US4633874A (en) | 1984-10-19 | 1987-01-06 | Senmed, Inc. | Surgical stapling instrument with jaw latching mechanism and disposable staple cartridge |
US5104025A (en) | 1990-09-28 | 1992-04-14 | Ethicon, Inc. | Intraluminal anastomotic surgical stapler with detached anvil |
US5389098A (en) * | 1992-05-19 | 1995-02-14 | Olympus Optical Co., Ltd. | Surgical device for stapling and/or fastening body tissues |
US5403312A (en) | 1993-07-22 | 1995-04-04 | Ethicon, Inc. | Electrosurgical hemostatic device |
US5597107A (en) | 1994-02-03 | 1997-01-28 | Ethicon Endo-Surgery, Inc. | Surgical stapler instrument |
EP0717960A2 (en) * | 1994-12-22 | 1996-06-26 | Ethicon Endo-Surgery | Electrosurgical hemostatic device |
EP0737446A1 (en) * | 1995-04-12 | 1996-10-16 | Ethicon Endo-Surgery, Inc. | Electrosurgical hemostatic device with recessed and deformable electrodes |
Non-Patent Citations (1)
Title |
---|
VAELLFORS, BERTIL AND BERGDAHL, BJOERN: "Automatically controlled Bipolar Electrocoagulation", NEUROSURG. REV., 1984, pages 187 - 190 |
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Also Published As
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CA2237429A1 (en) | 1998-11-14 |
JPH1170123A (en) | 1999-03-16 |
AU6487098A (en) | 1998-11-19 |
USH1904H (en) | 2000-10-03 |
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